Bilateral vocal fold immobility: diagnosis and treatment

Braz J Otorhinolaryngol. 2011 Sep-Oct;77(5):594-9. doi: 10.1590/s1808-86942011000500010.
[Article in English, Portuguese]

Abstract

Vocal fold immobility may be due to bilateral neurogenic paralysis, cricoarytenoid joint fixation, laryngeal synechiae, or posterior glottic stenosis. Treatment aims to establish a patent airway and preserve the function of the glottic sphincter and voice quality.

Objectives: To analyze the diagnostic and therapeutic approaches in cases of bilateral vocal fold immobility seen at our unit.

Materials and methods: A retrospective study of 35 patient registries at our unit with a diagnosis of bilateral vocal fold immobility; the etiology and treatment results were evaluated.

Results: Among the patients, 18 (51.4%) were cases of bilateral vocal fold palsy, and 17 (48,6%) were cases of posterior glottic stenosis. Patients with bilateral palsy underwent unilateral subtotal arytenoidectomy, and patients with stenosis were treated with the microtrapdoor flap technique, subtotal arytenoidectomy, and/or posterior cricoidotomy (Rethi).

Conclusion: Bilateral vocal fold immobility is a potentially fatal condition; it is essential to differentiate vocal fold palsy from fixation to choose the appropriate treatment. Subtotal arytenoidectomy with microscopy is our surgery of choice for treating bilateral paralysis; the technique for treating stenosis depends on the amount of stenosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Glottis / physiopathology
  • Humans
  • Laryngoscopy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Vocal Cord Paralysis / diagnosis*
  • Vocal Cord Paralysis / etiology
  • Vocal Cord Paralysis / surgery*
  • Young Adult