Abstract
Iwamura first reported Lateral cricoarytenoid muscle-Pull (LCA-Pull) for unilateral vocal cord paralysis in 1996. The lateral cricoarytenoid muscle is most important for vocal cord adduction. Treatment aims at reproducing natural adduction by pulling the lateral cricoarytenoid muscle. This result in the vocal fold being shifted medially and the difference in the vertical position being corrected. For surgical treatment of unilateral vocal cord paralysis, thyroplasty type I or fat injection has been indicated when the vertical vocal cord position is about the same and when distance between the vocal processes is short. Arytenoid adduction was employed when the vertical position is different. Both types of patient can be managed by LCA-pull, since the procedure leads to the reproduction of natural adduction. Another advantage is the simplicity of the surgical method, in which a small opening is made in the thyroid cartilage for traction and fixation of the lateral cricoarytenoid muscle. Consequently, the incidence of airway complications due to postoperative edema is low. Because the operation is done through the lamina of the thyroid cartilage, scarring due to previous cervical surgery won't be an additional factor in the level of surgical complication.
