Reversible immediate and definitive lateralization of paralyzed vocal cords

The author reports on glottis dilation operations based on the endoextralaryngeal suture technique he has developed. In all, 101 patients were operated on for bilateral recurrent nerve paralysis using different variations of the above method, of which 73 have had more than 1 year of follow-up. Dilation was performed in 52 patients following tracheostomy, whereas no tracheostomy was performed in 21 patients. In 9 cases irreversible laterofixation without tracheostomy was performed with good results. In 12 patients a reversible glottis dilating operation was carried out without tracheostomy not long after the development of bilateral paramedian position of the vocal cords. Tracheostomy was necessary in 1 of 12 patients, who underwent reversible glottis dilating operations. In this case later reoperation, using a definitive endoscopic glottis dilating operation, was performed with success. Three patients required reoperation using open surgical procedures after irreversible endoscopic laterofixation methods.