This retrospective study reviewed our 13-year experience in surgical treatment of 19 adults with bilateral vocal fold paralysis (BVFP). Symptoms, etiology and surgical methods were analyzed and compared with current medical literature. The primary complaint in all patients was dyspnea. Dysphonia was present in 58% and dysphagia in 32% of patients. The most common cause of BVFP was thyroidectomy, followed by unknown etiology, stroke and lung cancer, and isolated cases of polytrauma, neck abscess, and bilateral carotid artery operation. Tracheotomy as primary surgical intervention was performed in 58% and transoral endolaryngeal procedure in 42% of patients. Among tracheotomized patients, 64% of them underwent transoral endolaryngeal surgical procedure and 55% were decannulated. The most frequent endolaryngeal surgical procedure was subtotal arytenoidectomy (47%), followed by cordectomy and posterior cordotomy. Twenty-six percent of patients were surgically treated more than once. Objective respiratory, phonatory and swallowing evaluation was not performed routinely. The overall clinical features and surgical treatment of BVFP were in accordance with medical literature. Due to a relatively small number of cases in general population and the lack of comparative studies based on algorithmic approach, there is no clear evidence that one surgical technique is functionally superior to the other.
Hadžibegović et al. (Wed,) studied this question.