Background: Bilateral vocal fold paralysis (BVFP) is characterized by narrowing of the respiratory glottic chink which could present in the form of an acute airway insufficiency. The aim of this study is to evaluate the efficacy of combined laser posterior cordotomy and endoscopic suture latero-fixation on respiration and phonation. Patients and Methods: This study was a randomized controlled trial, conducted on forty patients, divided into 2 groups: Group (A) included 20 patients underwent combined laser posterior cordotomy and endoscopic suture latero-fixation, while group (B) involved 20 patients subjected to laser posterior cordotomy without latero-fixation for managing BVFP. Results: Group A showed a statistically significant shorter time interval of decannulation from tracheostomy tube after the procedure. (P=0.032). No significant difference between both techniques regarding adequacy of respiratory chink, decannulation rate and voice handicap index scores. Conclusion: Combined laser posterior cordotomy and endoscopic suture latero-fixation is a safe, minimally invasive and effective technique for treatment of BVFP with comparable effect to conventional laser posterior cordotomy regarding respiration and phonation.

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