A Combined Endolaryngeal Approach for Bilateral Vocal Fold Immobility: Microlaryngoscopic Submucosal Cordotomy and Endo-Extralaryngeal Triple-Suture Lateralization

Bilateral vocal fold immobility (BVFI) is a challenging clinical entity for laryngologists. The voice may be nearly normal, but mostly there is a severe inspiratory deficiency. The patients may need surgical interventions primarily for life-threatening dyspnea. While treating the dyspnea, dysphonia appears to be a problem to a certain extent. It is necessary to maintain a balance between providing a serviceable voice and prevention from further surgery for relapsing dyspnea. In the literature, there are various techniques which have been introduced for the surgical management of BVFI. In this report we present a modified approach performed on a BVFI patient, targeting to balance between dyspnea and dysphonia.