Coblation Assisted Kashima Surgery: A Cross Sectional Study

Abstract

Background: Managing individuals with bilateral vocal fold abductor paralysis is difficult and frequently requires surgery. It necessitates a delicate balance between airway and phonation. In this article, we discuss our experience with coblation in posterior cordotomy to treat patients with bilateral abductor paralysis (Coblation assisted Kashima Surgery). Patients and Methods: A prospective study was done among 27 patients with bilateral vocal fold paralysis who underwent coblation assisted Kashima surgery at our tertiary care hospital. The handicap index and dyspnoeic scores were assessed before and after surgery. All patients were tracheostomised and after successful Kashima surgery, the tracheostoma was closed. Patients were followed up for a period of 3 months for worsening of voice/ dyspnoea/ aspiration. Results: Of the 27 patients, 19 were males and 8 were females, most common aetiology of the vocal cord palsy was subsequent to thyroid surgery (Total thyroidectomy). The study showed that there was a significant mean difference between pre and post-tests among patients with dyspnoea index with P-value < 0.05 i.e., 0.02 . It also showed that there was significant mean difference between pre and post-tests among patients with VHI Index with P-value < 0.05 i.e., 0.04 . Conclusion: Kashima operation gives good results with respect to airway improvement. Voice outcomes vary from patient to patient, however overall patient satisfaction with respect to voice was good.