Abstract
In this paper, we report two cases with glottal obstruction following total thyroidectomy, who were successfully treated with thyroplasty type IV. They had received tracheostomy for a management of dyspnea immediately after the thyroidectomy. Dyspnea had persisted against several kinds of surgical intervention to widen glottal space or conservative treatment. Endoscopic observation showed bilateral false vocal folds bulging and glottal shortening in anteroposterior direction with paralysis of the vocal folds. Bilateral cricothyroid muscle dysfunction was thought to be a main cause of these findings. Therefore, thyroplasty type IV by Isshiki was performed in combination with unilateral arytenoidectomy in one case and partial resection of the false vocal folds using CO2 laser in the other. After the procedures, sufficient glottal space was obtained, and tracheostoma was successfully closed in both cases.
