Phonosurgery for Unilateral Vocal Cord Paralysis

Thyroplasty type I (Isshiki) in 15 cases and arytenoid rotation operation (Isshiki) in 11 cases were performed among the cases with unilateral vocal cord paralysis. And the following results were obtained. 1. Postoperatively, the misdegultition disappeared in all 5 cases who suffered from the marked misdegutition within one month after the onset of paralysis. 2. A definite improvement in both hoarseness and maximum phonation time (MPT) was observed in all cases postoperatively. However, the improvement was generally transient, and the moderate degree of hoarseness recurred within one month after the surgery. The transient improvement was considered to be facilitated by local edema of the vocal cord, elicited by, operative manipulations. 3. A combination of voice training with silicone injection into the vocal cord was attempted for the management of postoperative recurrence of hoarseness. And good results were obtained. 4. It was concluded that a combined approach including laryngeal framework operation, silicone injection and voice training should be necessary for the treatment of hoarseness due to the unilateral vocal cord paralysis.