Abstract
A 40 year-old man had suffered from breathy hoarseness for 6 years since left parapharyngeal vagal neurilemoma was extirpated. Paralytic vocal fold was fixed between the median to paramedian position. Although the left vocal fold was slightly abducted (paradoxical movement) when raising his voice, the posterior glottis was closed during sustained phonation. He was performed thyroplasty type I because of atrophy of the paralytic vocal fold and little positional difference in vertical direction between the bilateral vocal fold. His voice was improved after the operation. However, he complained of dysphonic vocal onset. Videostroboscopic examination revealed more prominent paradoxical movement of the left vocal fold than that before the operation. Therefore, we consider that the combination of thyroplasty type I with transection of the recurrent laryngeal nerve branch of the posterior cricoarytenoid or the muscle itself is required to eliminate paradoxical movement of the paralytic vocal fold.
