Laser lateralization for bilateral vocal cord abductor paralysis

Area of Science:

• Otolaryngology
• Laryngeal Surgery
• Vocal Cord Function

Background:

• Bilateral vocal cord immobility often necessitates tracheotomy.
• Effective surgical interventions are crucial for restoring airway and voice.
• Previous treatments had varying success rates.

Purpose of the Study:

• To evaluate the efficacy of unilateral laser excision of the thyroarytenoid muscle and suture lateralization for bilateral vocal cord immobility.
• To assess voice outcomes and the need for revision surgery.

Main Methods:

• Surgical technique involved unilateral laser excision of the thyroarytenoid muscle.
• Vocal ligament lateralization was achieved using sutures.
• Patient outcomes were assessed based on voice quality and airway patency.

Main Results:

• The combined surgical approach was successful in 13 out of 14 patients (93%).
• All patients achieved a satisfactory voice post-operatively.
• Revision surgery was required in four patients due to cricoarytenoid fixation or vocal cord paralysis.

Conclusions:

• Unilateral laser thyroarytenoid muscle excision with suture lateralization is a highly effective treatment for bilateral vocal cord immobility.
• The procedure offers a high success rate for voice restoration and airway management.
• Understanding causes of revision surgery is important for optimizing patient selection and outcomes.