All seven patients with tracheostomies in a 30-person retrospective study were successfully decannulated after a modified posterior cordotomy, while the report described improved airway and swallowing measures and no clinically meaningful postoperative worsening on a voice measure. Decannulation is the term used for removing a tracheostomy tube. The treatment was a surgical procedure carried out through the mouth with CO₂ laser microsurgery. The authors interpreted the pattern as an association with better airway and swallowing outcomes and minimal impact on voice-related quality of life.
Who was studied
The study set out to describe surgical and functional outcomes, with particular attention to airway function, swallowing and voice. It was a retrospective clinical investigation of patients treated between June 2017 and August 2024. Outcomes were assessed before and after surgery using videolaryngoscopy and three patient-reported measures: ADVS for airway function, EAT-10 for swallowing and VHI-30 for voice.
The participants were a narrowly defined group. All 30 were women, with a mean age of 55.53 years. The report classified every case as iatrogenic and said 100% were post-thyroidectomy. Seven patients had tracheostomies. This composition sets a clear boundary around the findings: they describe the cohort that was studied.
What the report found
On the airway and swallowing measures, the report described improvement in ADVS airway function, particularly in domains A and D, and in the EAT-10 swallowing measure. It did not provide the numerical preoperative and postoperative scores or a calculated effect size, so the direction of the reported change is clearer than its magnitude.
The voice finding was narrower. VHI-30 showed no clinically meaningful postoperative worsening, but numerical VHI-30 values and a statistical comparison were not supplied. The result is therefore more precisely described as an absence of meaningful worsening than as a quantified improvement in voice. The authors described the procedure's effect on voice-related quality of life as minimal.
All seven patients with tracheostomies were successfully decannulated after surgery. The same outcome statement showed 23%, although the report does not explicitly identify the denominator for that percentage. The count is the clearest part of this result. Follow-up duration was not reported, so the durability of decannulation remains unknown.
The study also reported peak expiratory flow, or PEF%, a breathing measure, for 20 of the 30 patients. The mean was 62.8%, the median was 64.5%, and the range was 35% to 82%. These were descriptive figures; no comparative PEF analysis or additional variability measure was reported.
What the findings do not settle
The report's conclusion said no revision surgery was required. The design limits the strength of any broader claim. This was a retrospective before-and-after study with no reported randomization or separate control group, so it can show what was observed in this cohort but cannot by itself establish that the operation caused the changes.
The authors reported no financial support for the research, authorship or publication and declared no potential conflicts of interest. The citation record lists acceptance on 3 August 2026 and publication of the version of record on 20 August 2026.
Paper data and sources
Original title: Modified transoral COlaser posterior cordotomy for bilateral vocal fold paralysis: surgical and functional outcomes.
Authors: Alfred Aga, Aranit Shkurti, Kristian Pacaj et al.
Journal/Repository: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
Status: Peer-reviewed
First online: 2026-08-20
DOI: 10.1007/s00405-026-10543-y
Original paper · Full text