The surgical treatment of bilateral vocal fold impairment

Bilateral vocal fold impairment is a potentially life threatening condition. The otolaryngologist must be able to quickly identify its etiology and select the appropriate surgical procedure to treat the airway obstruction while attempting to maintain phonation and deglutition. Multiple techniques, both endoscopic and open, are available to the surgeon in treating this clinical problem. Endoscopic procedures covered in this article are: arytenoidectomy; including laser and laser medical arytenoidectomy; suture lateralization; and partial posterior laser cordectomy or transverse cordotomy. Posterior lateral extralaryngeal arytenoidectomy and laryngeal reinnervaiton are discussed in regard to open techniques.