Struggling to Breathe Due to Vocal Cord Paralysis? Here Is How Laser Cordotomy Can Help You Breathe Easily Again

Do you feel short of breath, tight in your chest, or like something is stuck in your throat when you talk, swallow, or simply rest? Sometimes, this frightening feeling happens because both of your vocal cords are not working properly. When your vocal cords cannot open correctly, getting enough air into your lungs becomes a daily struggle.

If you or someone you love faces this challenging condition, modern medicine offers safe and effective options to help you breathe freely again. Today, we will explore a minimally invasive surgical treatment called laser cordotomy in clear, easy-to-understand plain English.

What is Laser Cordotomy?

Laser cordotomy is a surgical procedure performed by an ear, nose, and throat doctor to widen your breathing passage without making any cuts on the outside of your neck. To understand how it works, imagine your two vocal cords as a pair of double doors in a hallway. Normally, those doors swing open when you take a breath to let air flow freely into your lungs.

When you have vocal cord paralysis, those two doors get stuck close together and only open by a tiny fraction. Because the opening is too narrow, fresh air cannot pass through easily, leaving you gasping for breath. During laser cordotomy, your surgeon uses a precise laser beam to make a very small cut in one of your vocal cords.

This tiny cut creates extra space between your vocal cords so air can flow smoothly in and out of your lungs. Because the surgeon operates entirely through your mouth using specialized instruments, you will not have any visible scars on your neck after the procedure.

Who Benefits From This Treatment?

Doctors primarily recommend laser cordotomy for a specific and serious condition known as bilateral vocal cord paralysis. In this medical condition, both of your vocal cords lose their ability to move outward. Instead of opening wide when you inhale, they remain fixed close to the midline of your throat.

This abnormal closure severely narrows your main airway. As a result, you may experience persistent shortness of breath even when resting, noisy breathing or a high-pitched whistling sound when you inhale, and sometimes trouble swallowing food or speaking clearly. Laser cordotomy directly targets this airway blockage to restore normal airflow.

Cordotomy vs. Cordectomy: What Is the Difference?

People often confuse cordotomy and cordectomy because the names sound very similar, but these two procedures serve completely different medical purposes. Reviewing the comparison table below will help clarify how they differ.

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How to Prepare for Your Surgery

Your surgical care team will give you clear, step-by-step instructions on how to prepare for your laser cordotomy procedure. Before the surgery takes place, your doctor and speech specialist will evaluate several important aspects of your vocal health and breathing capacity.

Your medical team will carefully check the strength and force of your airflow when you speak. They will test your overall breathing endurance and lung function. They will examine how well your vocal cords move or fail to move, and they will evaluate the natural quality of your voice.

A speech-language pathologist will record detailed video images of your throat and vocal cords before the operation. This baseline video records the exact size of your narrowed airway and the exact position of your paralyzed vocal cords. After your surgery, your doctor will take another video to measure how much your airway has improved.

What Happens During the Surgery?

Your laser cordotomy procedure is performed while you are completely asleep under general anesthesia. Because you are fast asleep, you will not feel any pain or discomfort during the entire operation. Once you are safely asleep, your surgeon follows these precise steps:

1. The surgeon gently inserts a specialized lighted tube called a laryngoscope through your mouth and down your throat to get a clear, magnified view of your larynx and vocal cords.

2. To protect the delicate tissues located just below your vocal cords from any accidental heat or injury, the surgeon places a small, moistened protective sponge in your airway.

3. Finally, the surgeon uses a highly focused laser beam to make the precise small cut in one vocal cord (or sometimes both, depending on your specific needs).

This entire surgical procedure is quick and efficient, usually taking between 30 and 60 minutes from start to finish.

What Are the Benefits of This Treatment?

Before laser cordotomy became widely available, many people suffering from severe bilateral vocal cord paralysis had to undergo a major surgery called a tracheostomy. In a tracheostomy, a surgeon makes a surgical opening directly into your windpipe through the front of your neck and inserts a breathing tube.

Laser cordotomy helps improve your breathing, makes swallowing easier, and protects your voice function while helping you maintain a high quality of life. Also, if you already live with a tracheostomy tube, laser cordotomy can often open your airway enough for your doctor to safely remove the breathing tube altogether.

Are There Side Effects or Risks?

While laser cordotomy carries greatly fewer risks than major open neck surgeries, any surgical procedure carries minor potential risks. Your doctor will discuss these possibilities with you before your operation:

• Mild bleeding within the voice box or throat area.
• Minor irritation or bruising on your lips, teeth, or palate caused by inserting the laryngoscope tube.
• Temporary swelling around your vocal cords right away following surgery.
• Formation of small amounts of scar tissue around the treated vocal cord.

Most of these side effects are mild, temporary, and resolve quickly as your body heals. Your doctor will monitor you closely to prevent and manage any discomfort.

Recovery and What You Need to Do

Healing completely after a laser cordotomy procedure usually takes about three months. In some cases, to achieve the absolute best breathing results, your doctor may recommend a minor follow-up procedure called a revision cordotomy.

During your healing period, doing steam inhalation is a wonderful way to soothe your healing vocal cords and keep your throat moist. To help your tissues heal properly, your doctor will also order strict vocal rest. During this resting period, you must avoid the following activities:

• Speaking loudly or shouting.
• Clearing your throat forcefully or coughing too hard when possible.
• Singing or humming.
• Whispering loudly, which can actually strain your vocal cords more than soft talking.

After surgery, you will stay in the hospital for about 24 hours so your healthcare team can monitor your breathing closely. During this observation window, nurses may give you intravenous (IV) steroids to control any swelling around your vocal cords. Once you return home, your doctor may prescribe oral antibiotics, steroid pills, and anti-reflux medicines for one to three weeks to protect your throat.