Abstract
Bilateral vocal fold immobility presents a challenging problem for the otolaryngologist. Although some patients may be managed without intervention, most patients with bilateral true vocal fold immobility require airway management. The goals of such management are usually aimed at producing a safe tracheotomy-free airway, with preservation of deglutition and phonation. Two surgical treatment methods for bilateral true vocal fold immobility are presented: endoscopic submucosal arytenoidectomy with suture lateralization and endoscopic cordotomy with anterolateral arytenoidectomy. The two techniques with their indications, advantages, and complications are illustrated. These modified techniques have resulted in significantly lower rates of the troublesome complication of granuloma formation. Both methods yield a satisfactory glottic airway while maintaining both speech and swallowing.
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