Screw nail medialization of arytenoid in unilateral adductor vocal cord paralysis: A new office procedure

ObjectivesThe aim of this study is to describe and evaluate new technique for treatment of unilateral vocal cord paralysis giving the same results of the standard procedure but minimizing the surgical trauma.Patients and methodsA prospective study was carried out between November 2009 and November 2011 in the Otorhinolaryngology Department, Zagazig University Hospitals, Egypt. It included 12 patients with unilateral idiopathic vocal cord paralysis who were managed by this new technique. Preoperative and postoperative video-laryngoscopy was done, maximal phonation time was calculated and ratings grade of dysphonia was compared.ResultsPostoperative video-laryngoscopy relieved complete glottic gap closure in 83.3% of cases and partial glottic gap in the remaining 16.7% of cases. The mean preoperative maximal phonation time was 9.42 s and the postoperative value was 21.5 s with a mean difference of 11.6 s. The rating of the grade of dysphonia showed great improvement in the patient’s voice quality from severe dysphonia preoperatively to normal or near-normal voice postoperatively. All patients were satisfied with the results of the procedure except one patient (8.3%).ConclusionThe screw nail medialization technique gives a good reliable and easy procedure under local anesthesia for managing unilateral vocal cord paralysis and avoids the disadvantages of infection laryngoplasty and medialization thyroplasty using implants.