Pathophysiology and Surgical Treatment of Unilateral Vocal Fold Paralysis

Phonosurgical treatment for paralytic dysphonia was first established in the late 1970 s in the form of arytenoid adduction and medialization laryngoplasty. It made it possible to improve post-op patients voices, but it was difficult to regain patients own pre-paralysis voices. It has recently been established that immediate reconstruction of the recurrent laryngeal nerve is effective in recovery of their original voices in patients with unilateral vocal fold paralysis (VFP). Nerve muscle pedicle (NMP) flap implantation with a refined technique to the thyroarytenoid muscle is a novel method for that purpose. NMP flap implantation combined with arytenoid adduction was applied by the author to patients suffering from dysphonia and most patients did recover their nearly-normal voices after surgery. In this book, the readers will learn (1) what the presently prevalent surgical procedures are, (2) unsatisfactory results of these conventional procedures, (3) results of immediate recurrent laryngeal nerve reconstruction during tumor extirpation, (4) the outcome of delayed reinnervation combined with arytenoid adduction in patients with VFP, and, further, (5) the scientific basis which explains the reasons why the author s method is effective in the recovery of patients own pre-paralysis, normal voices. All laryngologists, especially general ENT doctors who see patients with paralytic dysphonia, and speech pathologists will benefit from the book s coverage of many basic and clinical aspects of reinnervation in retrieving patients normal voices.