Arytenoid Separation for Impaired Pediatric Vocal Fold Mobility

Abstract

Impaired vocal fold motion may result from cricoarytenoid joint fixation, bilateral vocal fold paralysis, or interarytenoid scarring. Traditional surgical techniques have focused on lateralization or resection of the arytenoid for airway improvement. This paper discusses 3 cases of bilateral reduced vocal fold motion of neurogenic cause treated with posterior cricoid grafting to cause a wider resting position of the vocal folds and arytenoids. Airway improvement occurred in all. The voice results have been encouraging. Advantages of this procedure are that the vocal folds are symmetric, there is no vocal fold or joint scarring, and the larynx remains a candidate for electrical pacing when that becomes available. Acoustic and aerodynamic voice results are presented. The results should be considered preliminary.