A surgical procedure on the posterior part of the vocal fold, first described to our knowledge by Dr. Haskins Kashima of Johns Hopkins University many years ago. The procedure is done for bilateral vocal fold paralysis or for glottic stenosis caused by injury and resultant scarring of the [intlink id=”639″ type=”post”]vocal folds[/intlink] together. Typically, an individual undergoes this procedure because of [intlink id=”590″ type=”post”]tracheotomy-dependence[/intlink] or because of marked [intlink id=”179″ type=”post”]exercise intolerance[/intlink]. The procedure is performed endoscopically, using the laser to make an incision across the posterior end of the most damaged or least functioning vocal fold. Inherent to this problem, and to this solution, is the idea that one trades away a little bit of voice to gain a little bit better airway.