[Surgical treatment of the bilateral abductor paralysis]

27 patients with bilateral vocal cord paralysis were treated in the First Clinical Medical College of Beijing Medical University, and all of them were followed up at least one year after treatment. According to the length of the vocal cord and the degree of the anterior angle of the thyroid cartilage, one of the three different surgical procedures would be selected to alleviate the symptoms of bilateral abductor paralysis. The width of glottic chink after treatment is the paramount index. The average estimated size of the posterior glottic chink or point of maximum width of glottic chink should be equal to or bigger than 4mm after surgical treatment. The open approach to arytenoidectomy-Woodman's Technique was performed in 15 patients, and among them the tracheal cannulas were removed in 11 cases, and 8 cases had a glottic chink bigger than 4mm width. In 9 cases with short length vocal cord and narrow anterior angle of the thyroid cartilage, a modified hemilaryngectomy was used by thyrotomical approach, and a successful result was obtained with good to excellent exercise tolerance for social activity. Unfortunately, in the remaining 3 patients, the nerve-muscle pedicle technique reinnervation of bilateral vocal cord paralysis was applied, and no patient demonstrated visible inspiratory vocal cord abduction. Although this type of operation might totally reconstruct respiratory function without phonation impairment, the clinical result was not certain.