Bilateral vocal fold immobility: diagnosis and treatment.
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.


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


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).


CONCLUSIONS
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.
Otorhinolaryngology and Head & Neck Surgery Unit, São Camilo Hospital and Maternity-Pompeia.
José Antonio
JA
Pinto
Luciana Ballester de Mello
LB
Godoy
Valéria Wanderley Pinto
VW
Marquis
Thiago Branco
TB
Sonego
Carolina de Farias Aires
Cde F
Leal
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005931:Glottis / Q000503:physiopathology; D006801:Humans; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D055815:Young Adult