Objective : To study the efficacy of laterofixation for bilateral vocal fold immobility (BVFI) in adduction.
Study design and Methods : We retrospectively analyzed the outcomes of laterofixation as the initial surgery for tracheostoma closure in nine patients who underwent tracheostomy for airway narrowing due to BVFI in adduction at Toho University Omori Medical Center from 2007 to 2016 and an additional patient who underwent surgery at Yokohama City University Hospital in 2017. The study examined the possible causes of BVFI in each subject, the endoscopic findings of the posterior glottis and subglottis, the results of electromyographic examinations and the intraoperative traction and mobility tests. Results : Based on the results of examinations, the 10 cases were classified into 2 groups: 4 with bilateral vocal fold palsy (BVFP) and 6 with posterior glottic stenosis (PGS). Successful tracheostoma closure by laterofixation was achieved in all of the BVFP patients but in only two of the PGS patients. Conclusions : Laterofixation is a simple operation that can be performed at any facilities performing direct laryngoscopy. However, the efficacy of the operation appears to be limited, particularly in cases retaining laryngeal muscle tonus, such as in PGS patients.
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