Management of impaired vocal fold movement during sleep in a patient with Shy-Drager syndrome.

A 46-year-old woman with Shy-Drager syndrome is presented. She has impaired vocal fold abduction during sleep, but has no laryngeal dysfunction while she is awake. In order to reduce laryngeal obstruction during sleep, she initially underwent laterofixation of 1 vocal fold (Ejnell's method) with little lasting success because of accidental slipping of the ligature. Later, she successively underwent arytenoidectomy with the use of CO2 laser. Her noctural breathing improved markedly after arytenoidectomy.