Combined Endoscopic and External Surgical Approach for Lateralization of Vocal Cord in Bilateral Abductor Palsy using Suture Technique: Our Experience

Introduction: Bilateral vocal cord paralysis is a rare but dangerous condition which results in shortness of breath and poor quality of voice. Only patients with severe bilateral vocal cord immobility require surgical intervention. In the present study, we describe the procedure of combined endoscopic and external surgical approach for lateralization of vocal cord in bilateral abductor palsy. Objective: The objective of this study is to analyze the surgical outcome of combined endoscopic and external surgical approach for lateralization of vocal cord using suture technique in bilateral abductor palsy. Materials and methods: An observational study was conducted on 17 patients presenting in ENT Department during May 2014 to July 2016 with laryngeal lesions of bilateral abductor palsy with posterior glottic chink of 3 mm or less, stridor at rest, and significant limitation of physical activity due to airway narrowing. Observations: In the present study, we have performed suture lateralization of vocal cords in 17 patients. Of these, 11 (64.70%) were female and 5 (29.41%) were male with slight female preponderance. Mean age of performing procedure was 39 years with the patients in age group of 18 to 60 years. When clinical etiology of the patients leading to bilateral vocal cord palsy was observed, patients presenting with postsurgical causes appeared to develop bilateral vocal cord palsy in 47.05% of patients. During the study, it was observed that improvement in respiration was adequate in 16 (94.11%) patients, and voice quality was socially acceptable in 16 (94.11%) patients. Discussion and conclusion: Surgery of laterofixation can provide immediate and long-lasting adequate airway and can be considered as minimally invasive with minimal alterations to laryngeal mucosa and subsequent preservation of laryngeal functions. This procedure appears efficient in management of bilateral vocal cord palsy.