Transverse cordotomy is a surgical procedure on the posterior part of the vocal cord, first described to our knowledge by Dr. Haskins Kashima of Johns Hopkins University many years ago. The procedure is done for bilateral vocal cord paralysis, or for glottic stenosis caused by injury and resultant scarring of the vocal cords together. Typically, an individual undergoes this procedure because of tracheotomy dependence or because of marked exercise intolerance. The procedure is performed endoscopically, using the laser to make an incision across the posterior end of the most damaged or least functioning vocal cord. 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.