A Review of Treatment of Bilateral Vocal Fold Movement Impairment

Abstract

Purpose of Review Bilateral vocal fold immobility is a challenging life-threatening problem involving multiple treatment options and nuanced clinical decision making. We aim to provide relevant background on the etiology, diagnosis, and management of bilateral vocal fold movement impairment (BVFMI). Recent Findings Over the last 20 years, the management of bilateral vocal fold immobility has advanced significantly with the addition of multiple endoscopic approaches as well as procedures with the goal of returning dynamic function to the larynx, among them: selective reinnervation. Chemodenervation has also demonstrated promising results as a temporizing procedure in appropriately selected patients with BVFMI. Summary Tracheostomy remains the mainstay of emergent treatment for airway obstruction secondary to bilateral vocal fold immobility. However, recent advances in endoscopic approaches allow for avoidance of tracheostomy in many patients. Developments in dynamic procedures with the aim of restoring laryngeal function allow for adequate airway management while maintaining voice quality and limiting aspiration risk.

Aktive und passive Bioimplantate bei Stimmlippenlähmung

“…The effect onset of re-innervation may be expected between 6 and 9 months after surgery. In an evaluation published by Marie et al [177], decanulation could be performed in 35 of 40 patients by means of this therapy. In 30 patients, the respiratory parameters were improved.…”

“…Das Wirksamwerden der Reinnervation ist zwischen 6 und 9 Monaten nach der Operation zu erwarten. In einer von Marie et al 177 angegebenen Auswertung von 40 Patienten konnten 35 mit dieser Therapie dekanüliert werden, bei 30 verbesserten sich die Atemparameter. In 27/40 Fällen konnte mindestens einseitig und bei 16/40 beidseitig eine atemsynchrone Abduktion der Stimmlippen durch die selektive Reinnervation erreicht werden.…”