2020 Volume 32 Issue 02 Pages 161-164
Previous epidemiological studies have indicated that bilateral vocal fold palsy (BVFP) is the most common cause of bilateral vocal fold immobility (BVFI), followed by posterior glottic stenosis (PGS) due to ankylosis of the cricoarytenoid joint, fixation and/or fibrosis at the posterior glottis. The differential diagnosis between BVFP and PGS is made based mainly on careful clinical history-taking, fiberscopic observation of the subglottal region through the tracheostoma, and performance of electromyography. Based on the our clinical findings of adducted-type BVFI thus far, we have suggested treatment options and a severity classification system of BVFI that focuses mainly on electromyography results for assessing dynamic restenosis and traction-mobility test results for assessing static restenosis. Both the surgical techniques of laser subtotal arytenoidectomy and laterofixation are effective and useful for widening the glottis in cases of BVFI. However, the deterioration of the voice quality in laser subtotal aryteenoidectomy is less marked than with laterofixation.
