Medialization laryngoplasty for the treatment of unilateral vocal cord paralysis: a perceptual, acoustic and stroboscopic evaluation.

Vocal cord paralysis remains a frustrating condition. The etiology can be subdivided roughly into surgically induced, neoplastic and idiopathic paralysis. In the surgical group, thyroidectomy is the most common cause. In unilateral vocal cord paralysis most patients suffer from a change in voice quality described as hoarseness or breathiness with or without aspiration and dysphagia. Laryngeal examination usually reveals the paralyzed cord shorter than the normal side and mostly in the paramedian position. Endostroboscopic examination shows invariably incomplete closure of the vocal cords with marked decrease in the mucosal waves of the folds during phonation. Several procedures for vocal cord medialization such as endoscopic injection of different materials, medialization thyroplasty, arytenoids adduction and re-innervation procedures have been described in the literature. Laryngoplastic phonosurgery for surgical rehabilitation of the paralyzed vocal cord has markedly evolved over the last few decades. This is a review of patients with unilateral vocal cord paralysis treated by medialization laryngoplasty at the American University of Beirut, Department of Otolaryngology Head and Neck Surgery, between 1994 and 2003. The etiology of the paralysis, symptomatology, endostroboscopic and acoustic findings will be presented together with a description of the surgical technique.