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Georg Mathias Sprinzl, MD; Hans Edmund Eckel, MD; Stephan Ernst, MD; Kambiz Motamedi, MD

Arch Otolaryngol Head Neck Surg. 1999;125:1154-1157.

Several open and endoscopic surgical techniques are available to provide an adequate airway for patients with bilateral vocal cord paralysis. Transoral laser arytenoidectomy has repeatedly been reported to be a reliable and effective minimally invasive procedure for airway restoration. To our knowledge, there have been no previous reports of serious complications, other than poor vocal results, aspiration, and failed decannulation in individual patients, that have resulted from this intervention. We report a case in which arytenoidectomy led to severe complications and death. Prior irradiation is suspected to be a causative factor. To prevent such an outcome, we believe that operative settings should be chosen that avoid deep thermal injury of the laryngeal framework.

From the Departments of Otorhinolaryngology–Head and Neck Surgery, University of Innsbruck, Innsbruck, Austria (Dr Sprinzl), and University of Cologne, Cologne, Germany (Dr Eckel), and the Departments of Radiology, University of Cologne (Dr Ernst) and Albert Einstein Medical Center, Philadelphia, Pa (Dr Motamedi).