Vocal fold lateralization using carbon dioxide laser and fibrin glue.

Lateralization of one or both vocal folds is a generally accepted surgical principle for the relief of the airway obstruction caused by bilateral vocal fold paralysis. A modified, entirely endoscopic method of lateralization has been developed, employing a carbon dioxide laser to reduce the bulk of the fold, and fibrin glue to maintain the lateral position. The results of 18 operations on 15 patients, including six who had unsatisfactory results after previous surgery, were analyzed and compared retrospectively with the results from 22 patients operated on before the introduction of the method. The patient's ability to perform everyday activities improved in 12 cases, which paralleled the results of the previous, more cumbersome methods. The incidence of re-operation was comparable, given the shorter follow-up after the more recent method.