A Clinical Study of Bilateral Recurrent Laryngeal Nerve Paralysis

Twenty-three patients with bilateral recurrent laryngeal nerve paralysis treated at our clinic over the past 15 years were studied. The vocal cord was fixed in a paramedian position in twelve patients, in a median position in ten patients and in our intermediate position in one patient. No surgical treatment was performed in ten patients, while thirteen patients were surgically treated. Surgical procedures were undertaken as follows: tracheotomy in three patients, endoscopic lateralization of the vocal cord by Kirchner's method in two patients, widening of the anterior glottis combined with Woodman's operation in one patient, arytenoidectomy in five patients, thyroplasty type I (Isshiki's method) in one patient, glottic closure in one patient and laryngectomy in one patient. From our long term observations, we think that arytenoidectomy is the simplest and most reliable method for reducing the laryngeal obstruction in bilateral recurrent nerve paralysis.