Direct pull of lateral cricoarytenoid muscle for unilateral vocal cord paralysis.
CONCLUSIONS
Lateral cricoarytenoid muscle-pull surgery (LCA pull) is a safe and effective method for the treatment of unilateral vocal cord paralysis.


OBJECTIVE
To evaluate the results of an improved method of LCA pull for unilateral vocal cord paralysis.


METHODS
Thirteen patients with unilateral vocal cord paralysis underwent LCA pull between April 2003 and January 2004. A small window was made in the posterior lower part of the thyroid cartilage and 2-3 mm in a cranial direction to the lower edge of the thyroid cartilage. The inner perichondrium was carefully removed to expose the LCA muscle. A 4-0 nylon suture placed through the LCA muscle was pulled to adduct the arytenoid and was tied to the anterior lower part of the thyroid cartilage. All cases were treated by LCA pull alone. In all cases, the maximum phonation time was measured and an auditory evaluation was performed using the grade, roughness, breathiness, asthenia and strain scale. The airflow rate was measured in five cases.


RESULTS
Vocal improvement was obtained in 11/13 cases (85%). One of the unimproved cases had cricoarytenoid joint ankylosis. No complications were observed.
Tokashiki
Ryoji
R
Department of Otorhinolaryngology, Tokyo Medical University, Tokyo, Japan. tokachanman@aol.com
Hiramatsu
Hiroyuki
H
Tsukahara
Kiyoaki
K
Yamaguchi
Hiroya
H
Motohashi
Rei
R
Suzuki
Mamoru
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D013314:Stress, Mechanical; D013957:Thyroid Cartilage / Q000601:surgery*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality