# Arytenopexy with medialization thyroplasty and cricothyropexy in the treatment of unilateral vocal fold paralysis: A 15-year experience

## TL;DR

A surgical technique combining three procedures improved voice and swallowing in patients with vocal fold paralysis over 15 years.

## Contribution

The study demonstrates the safety and effectiveness of combined arytenopexy, thyroplasty, and cricothyropexy under local anesthesia.

## Key findings

- Functional outcomes were satisfactory or optimal even in cases with posterior glottic gap.
- Most patients resumed oral feeding post-surgery with corrected aspiration and dysphonia.
- Long-term complications were rare and did not affect vocal outcomes.

## Abstract

•Combined arytenopexy, thyroplasty, and cricothyropexy improved voice in unilateral vocal fold paralysis.•All procedures were safely done under local anesthesia with sedation and no respiratory complications.•Functional outcomes were satisfactory or optimal, even in cases with posterior glottic gap.•Most patients resumed oral feeding post-op; aspiration and dysphonia were effectively corrected.•Long-term complications were rare and did not significantly impact vocal outcomes.

Combined arytenopexy, thyroplasty, and cricothyropexy improved voice in unilateral vocal fold paralysis.

All procedures were safely done under local anesthesia with sedation and no respiratory complications.

Functional outcomes were satisfactory or optimal, even in cases with posterior glottic gap.

Most patients resumed oral feeding post-op; aspiration and dysphonia were effectively corrected.

Long-term complications were rare and did not significantly impact vocal outcomes.

To evaluate our experience with the technique, functional results, and potential complications.

A retrospective study was conducted with a sample of 29 patients submitted to this surgical procedure between 2000 and 2015. All procedures were performed under local anesthesia with sedation, and without intercurrences. Hospitalization time was 24 h on average.

None of the patients presented respiratory distress that required tracheostomy. Regarding vocal quality, the results were considered satisfactory or optimal, with high degree of patient satisfaction. With respect to dysphagia, all patients who needed enteral nutrition resumed exclusive peroral diet.

Arytenopexy with medialization thyroplasty and cricothyropexy are procedures with low degree of complication that can be performed under local anesthesia with excellent functional results, even in patients with marked posterior glottic gap.

Level IV.