gms | German Medical Science

Introduction: The “simple” suture lateralization of the vocal cord(s) (VC) is one of the effective treatment options for the bilateral vocal cord immobility (bVCI).

Method: Between 1986 and 2006 146 patients with bVCI were treated at the ENT department of Szeged University. From 1995 a minimally invasive technique was applied in 112 patients (75 women, 37 men, ranged 18-81 years), which provided the lateralization of the arytenoid cartilage in a physiological abducted position by an endoscopically inserted suture loop. A new instrument is introduced for this procedure. The fixated cricoarytenoidal joints were previously mobilized by CO₂ laser and a special blade designed by the authors. 74 bVCIs were due to nerve injury, and in the most case of the 38 mechanical fixations developed after prolonged intubation.

Results: Immediate postoperative adequate airway was achieved in 102 cases. One patient required postoperative tracheostomy and in nine ones, the preroperatively existing tracheostomy must have been sustained for more than a week. Three of them remained canulated. Two elderly women were later tracheostomized for aspiration. After the recovery of the VC movement the suture was removed in 52 cases what ensured further voice improvement. In 46 of the 55 permanent bVCI the airway remained stable over a year.

Conclusion: This method is a good primary solution of bVCI, because it can provide immediate and stable airway with the preservation of the laryngeal function to a large extent.