Stiffness of the vocal cord in dysphonia-its assessment and treatment

Due attention does not seem to have been paid to the problem of vocal cord stiffness in dysphonia, because it is extremely difficult to assess and to treat. Four illustrative cases are presented where the stiffness deviation was apparently involved in the dysphonia and successfully treated by laryngeal framework surgery. A breathy, high-pitched, and strained voice may be suggestive of very stiff vocal cords. Manual pressure on the thyroid cartilage in various manners during phonation can provide us with useful information about the stiffness of the cords, and indication for surgery. Surgical A-P shortening of the thyroid ala reduces the stiffness, while cricothyroid approximation increases it.