[Laryngeal microsurgical laterofixation of paralyzed vocal cords using a new suture instrument]

Author reports on clinical experiences of a method--tried earlier on laboratory animals--for treatment of laryngostenosis following bilateral paralysis of the recurrent nerve. In 2 cases, laterofixation of the paralysed vocal cord only was performed with the help of their endo-extralaryngeal needle carrier instrument. In another 19 cases, medial and lateral fibres of the thyroarytenoid muscle were submucosally removed, then the remaining vocal cord laterofixed with through-stitches in the posterior and middle third, with the help of the endo-extralaryngeal needle carrier. The laterofixing thread was tied over a bent silicon tube, put on the skin of the neck. Threads were removed 2-3 weeks after the operation. The lumen of the larynx was found to be adequate after the operations. One patient was lost on the first postoperative day because of acute heart failure, and hence this case was disregarded at the final evaluation. Postoperative decannulation was successful in all of the 20 evaluated cases. The operations were performed by a laryngomicrosurgical method, without opening the larynx or otherwise disturbing the laryngeal cartilage.