Acta clinica Croatica, Vol. 64. No. 4, 2025.
Original scientific paper
https://doi.org/10.20471/acc.2025.64.04.09
Surgical Treatment of Bilateral Vocal Fold Paralysis: A 13-year Experience
Ana Đanić Hadžibegović
; Zagreb University Hospital Center, Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb, Croatia; University Josip Juraj Strossmayer, Faculty of Dental Medicine and Health, Osijek, Croatia
*
Ika Gugić Radivojković
; Zagreb University Hospital Center, Department of Otorhinolaryngology and Head and Neck Surgery, Zagreb, Croatia
Marin Gudelj
; Student, University of Zagreb, School of Medicine, Zagreb, Croatia
* Corresponding author.
Abstract
This retrospective study reviewed our 13-year experience in surgical treatment of 19
adults with bilateral vocal fold paralysis (BVFP). Symptoms, etiology and surgical methods were analyzed
and compared with current medical literature. The primary complaint in all patients was dyspnea.
Dysphonia was present in 58% and dysphagia in 32% of patients. The most common cause of BVFP was
thyroidectomy, followed by unknown etiology, stroke and lung cancer, and isolated cases of polytrauma,
neck abscess, and bilateral carotid artery operation. Tracheotomy as primary surgical intervention was
performed in 58% and transoral endolaryngeal procedure in 42% of patients. Among tracheotomized
patients, 64% of them underwent transoral endolaryngeal surgical procedure and 55% were decannulated.
The most frequent endolaryngeal surgical procedure was subtotal arytenoidectomy (47%), followed
by cordectomy and posterior cordotomy. Twenty-six percent of patients were surgically treated more
than once. Objective respiratory, phonatory and swallowing evaluation was not performed routinely. The
overall clinical features and surgical treatment of BVFP were in accordance with medical literature. Due
to a relatively small number of cases in general population and the lack of comparative studies based on
algorithmic approach, there is no clear evidence that one surgical technique is functionally superior to
the other.
Keywords
Bilateral vocal cord paralysis; Recurrent laryngeal nerve palsy; Vocal fold; Thyroidectomy; Cordotomy
Hrčak ID:
344715
URI
Publication date:
31.12.2025.
Visits: 391 *