[25 years experience with glottis widening surgery in our clinic (author's transl)]

Between 1949 and 1974, 137 patients with bilateral vocal cord paralyses were operated upon in our Department. In 127 cases King's method of extralaryngeal lateral fixation of the vocal cord or a modification thereof was executed on one or both sides. The modification consisted of securing the lateral-fixating suture around the superior thyroid cornu. This produces an additional displacement of the vocal cord in the vertical plane which provides good respiratory function in spite of only moderate lateral displacement of the cord. In seven cases endolaryngeal arytaenoidectomies and submucus hemicordectomies using Kleinsassers' technique were performed. In three cases endo- and extralaryngeal methods were combined. 120 (87.6%) of all patients could be decannulated. After unilateral extralaryngeal lateral cord fixation, 77.2% of patients could be decannulated within three weeks following operation. Operative results were analysed according to respiratory and vocal function two years postoperatively. After unilateral lateral cord fixation, breathing was good or sufficient in 73.6% of cases and insufficient in 26.4% of cases. The voice was normal or dysphonic in 86% of cases while aphonic in 14% of cases. Among the causes of bilateral vocal cord paralysis, primary strumectomies and operations for recurrent goiter were predominant (95%). All patients were tracheotomized before or after the operation. Two years postoperatively, incidental tracheal stenosis was noted in 73% of all patients. This was insignificant to moderate in 63.5% of cases and severe in 9.5% of the cases.