Unilateral laser excision of the thyroarytenoid muscle combined with suture lateralization of the vocal ligament was successful in 13 of 14 patients (93%) treated for bilateral abduction immobility sufficient to require tracheotomy. Among the four patients requiring revision surgery, three had cricoarytenoid fixation and one had vocal cord paralysis. All patients had a satisfactory voice after surgery. The anesthetic management of laser microsurgery is discussed.
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