Endoscopic lateralization of the vocal cord in abductor paralysis of the larynx.

Endoscopic surgical operations of the larynx have many desirable features, including the conservative nature of these procedures, plus the ability to produce surgical changes predictable from the onset. For several years the direct lateralization of the vocal ligament after the removal of a preassessed amount of thyroarytenoid muscle appeared to be the simplest and most accurate surgical procedure. The resection of this wedge of muscle was easily performed with laryngeal microcautery. Posterior cicatricial webs can be easily removed with this instrument. Simple suturing techniques are also described, including the practicability of using padded buttons plus lead fishing sinkers to adjust the tension and secure these sutures on the surface of the neck. So far 16 patients have been rehabilitated using this technique, including 6 patients with posterior commissure webs. These anatomical techniques should be considered because of their obvious simplicity.