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Korean Journal of Otorhinolaryngology-Head and Neck Surgery > Volume 38(12); 1995 > Article
Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1995;38(12): 2000-5.
Laterofixation of the Vocal Cord for Bilateral Vocal Cord Paralysis
Ki Hwan Hong, MD, Byung Am Park, MD, Kyung Ho Jung, MD, and Sang Sool Jung, MD
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Chonbuk National University, Chonju, Korea
양측성대마비에 대한 성대 측방고정술
홍기환 · 박병암 · 정경호 · 정상술
전북대학교 의과대학 이비인후과학교실

The most common cause of bilateral vocal cord paralysis is thyroidectomy. If the injury is to the recurrent laryngeal nerve only, the paralysed vocal folds assume a position very close to that necessary for phonation, but the real problem is airway compromise. Sooner or later, all patients with bilateral abductor paralysis have stridor. This may be present immediately after operation or may be precipitated later by an upper respiratory tract infection, so a tracheotomy is required. The form of therapy used to provide an adequate airway depends upon the patients individual needs and preference. There are those patients who will want to maintain a permanent tracheotomy, and a normal voice. There are others who will prefer decannulation by widening of the airway. But, the greater the lateralization achieved, the greater the chance of aspiration and the greater the degree of hoarseness. Vocal fold lateralization can be classified as lateral fixation of cord, arytenoidopexy, arytenoidectomy, and cordectomy. Reinervation of paralysed posterior cricoarytenoid muscle is theoretically superior to other means of glottic airway because there is no further loss of voice, but remains controversal now. In this study, we have had 4 cases of bilateral vocal fold paralysis with lateral fixation of the vocal fold, the results were all relatively satisfactory. The advantages claimed are that no perioperative tracheotomy is needed, the influence on the voice is adjustable, and if needed there remained the possibility of performing a more extensive surgical procedure.

Keywords: Bilateral vocal cord paralysisRecurrent laryngeal nerve.
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