Phrenic nerve graft for bilateral vocal cord paralysis.

For bilateral vocal cord paralysis, the phrenic nerve graft procedure has been used in five patients. Data from four of these patients suggest that the technique may in some way improve the glottic airway without long-term diaphragmatic paralysis. No patient to date has demonstrated visible inspiratory vocal cord abduction however. The mechanism of action, if any, is unclear at this time, and we have no electromyographic nor other physiologic data to confirm that true posterior cricoarytenoid muscle reinnervation has taken place.