Abstract
We have performed laryngeal framework surgery and/or intracordal injection of atelocollagen for 57 patients with unilateral vocal fold paralysis during the last 15 years. One of arytenoid adduction, type I thyroplasty and intracordal injection, or arytenoid adduction combined with either of the latter two methods was chosen based on stroboscopic and conventional tomographic findings. In a few patients who underwent type I thyroplasty, silicon block was placed slightly more rostrally than the vocal fold. We removed a small lateroinf erior portion of the thyroid ala to obtain an easier access to the muscular process during the procedure of arytenoid adduction. To decide a size of silicon block during type I thyroplasty, and direction and strength of a thread for traction of the muscular process during arytenoid adduction was a difficult step of each procedure. Paradoxical movement of the paralyzed vocal fold was rarely detected stroboscopically. CT endoscopic images seemed to be useful method to assess positional difference between both vocal folds in the superior-inferior direction and paradoxical movement of the paralyzed vocal fold during phonation.
