Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique for bilateral vocal fold immobility: long-term results

Abstract

Conclusions: Vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique is an effective and durable procedure for the management of patients with bilateral vocal fold immobility. Objectives: To review the long-term results of bilateral vocal fold immobility in 26 patients treated with vocal and ventricular fold lateralization using crossing sutures with the thyroplasty window technique over a 6-year period. Methods: This retrospective study examined patients with a minimum follow-up of 1 year. The main outcome measures used were the modified Medical Research Council (MRC) dyspnoea scale and the assessment of voice quality pre- and postoperatively using the Likert method. Results: The mean follow-up period was 23.77 ± 12.01 months. All patients reported marked symptomatic improvement in dyspnoea (p = 0.0001). The voice quality worsened as expected; however, this difference did not reach a significant level (p = 0.642). Transient microaspiration was noted in seven of the patients and resolved in 1 or 2 days. The procedure was performed for the contralateral vocal fold in one case, due to the loss of suture tension. No patient showed aspiration postoperatively or during follow-up. All patients were regularly followed up for the beginning of movement of the lateralized or contralateral vocal folds in our outpatient clinic.

Keywords::

• Bilateral vocal fold paralysis
• bilateral vocal fold immobility
• suture laterofixation
• tracheostomy
• vocal cord

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.