open access

Vol 71, No 4 (2020)
Review paper
Published online: 2020-08-14
Submitted: 2020-03-04
Accepted: 2020-04-30
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Methods of surgical treatment of bilateral vocal fold paralysis

Małgorzata A. Czesak, Ewa Osuch-Wójcikiewicz, Kazimierz Niemczyk
DOI: 10.5603/EP.a2020.0042
·
Pubmed: 32852048
·
Endokrynologia Polska 2020;71(4):350-358.

open access

Vol 71, No 4 (2020)
REVIEWS — Postgraduate Education
Published online: 2020-08-14
Submitted: 2020-03-04
Accepted: 2020-04-30

Abstract

Bilateral vocal fold paralysis presents as their complete or partial immobilisation. The median or paramedian position of vocal folds contributes to the narrowing of the airway at the level of the glottis and manifests as inspiratory dyspnoea. For many years iatrogenic injury of recurrent laryngeal nerves during thyroidectomy has been viewed as the most common underlying reason. It is very often a lifethreatening condition requiring not only corticosteroid administration and intubation, which only constitute a short-term symptomatic therapy, but also surgical intervention, including tracheostomy. The most common surgical methods implemented in bilateral vocal fold paralysis include posterior cordectomy, arytenoidectomy, and, more and more commonly, re-innervation. Other techniques used in restoring airway patency include laterofixation, botulinum toxin injection, and laryngeal stimulation, which is still under research. Stem cell and gene therapy are also being researched. Notably, the main purpose of surgical treatment is the provision of airway patency with
the preservation of the phonatory and protective functions of the larynx.

Abstract

Bilateral vocal fold paralysis presents as their complete or partial immobilisation. The median or paramedian position of vocal folds contributes to the narrowing of the airway at the level of the glottis and manifests as inspiratory dyspnoea. For many years iatrogenic injury of recurrent laryngeal nerves during thyroidectomy has been viewed as the most common underlying reason. It is very often a lifethreatening condition requiring not only corticosteroid administration and intubation, which only constitute a short-term symptomatic therapy, but also surgical intervention, including tracheostomy. The most common surgical methods implemented in bilateral vocal fold paralysis include posterior cordectomy, arytenoidectomy, and, more and more commonly, re-innervation. Other techniques used in restoring airway patency include laterofixation, botulinum toxin injection, and laryngeal stimulation, which is still under research. Stem cell and gene therapy are also being researched. Notably, the main purpose of surgical treatment is the provision of airway patency with
the preservation of the phonatory and protective functions of the larynx.

Get Citation

Keywords

bilateral vocal fold paralysis; larynx; microsurgery

About this article
Title

Methods of surgical treatment of bilateral vocal fold paralysis

Journal

Endokrynologia Polska

Issue

Vol 71, No 4 (2020)

Article type

Review paper

Pages

350-358

Published online

2020-08-14

DOI

10.5603/EP.a2020.0042

Pubmed

32852048

Bibliographic record

Endokrynologia Polska 2020;71(4):350-358.

Keywords

bilateral vocal fold paralysis
larynx
microsurgery

Authors

Małgorzata A. Czesak
Ewa Osuch-Wójcikiewicz
Kazimierz Niemczyk

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