Laryngoscopic findings in dysphonia following traumatic midbrain syndrome

: 26 patients with traumatic voice disorders were examined laryngoscopically. During the initial mute stage, reflex vocal cord movement could be detected but no intentional movement. A gradual approximation of the vocal cords led to a narrowing of the glottic aperture so that whispering but not voiced phonation, was possible (stage of whispering). The third stage was characterized by the rapid development of a laryngeal (and pharyngeal) spasticity, identifiable by shortened and thickened vocal folds, an increased approximation of the ventricular folds and in a more dorsal position of the epiglottis. During phonation hyperadduction of the anterior two thirds of the vocal cords occurred with an accompanying open posterior chink (stage of spastic dysphonia). In some patients an incomplete, unilateral vocal cord abduction during respiration was observed which is most probably the result of an unilateral (contralateral) laryngeal hemispasticity. In other patients spontaneous (uni- and bilateral) laryngeal hyperkinesias were also present.