LIV Paralysis of the Larynx

Certain Anatomical and Physiological Considerations in Paralysis of the Larynx

“…The third position is the paramedian [2,3], which leaves a posterior space of about 3*5 mm. between the cords.…”

“…It is the position used in certain forms of strong whisper, and in pathological states it is taken up in cases of complete paralysis of the recurrent laryngeal nerve, when both the abductors and the internal adductor muscles are out of action. The cords are brought into the paramedian position by the influence of the crico-thyroid muscles, which act as external adductors and rotators of the arytenoid cartilages, and thus as tensors of the vocal cords [2,3,5]. It is incorrect to say that in cases of complete recurrent paralysis the cadaveric position is taken up.…”

“…What is in dispute is the function of the superior laryngeal, which through its external branch gives inrcsration to the crico-thyroid muscles. It has been thought by some that the interarytenoid -mas also supplied by this nerve, but this view, according to Lemere and others, is incorrect [2,3]. It should be accepted that the superior laryngeal nerve supplies the crico-thyroid rruscle only and the recurrent, the intrinsic abductor and adductor muscles.…”

“…An excellent paper by Clerf and Suehs is of particular value in clarifying this problem [3]. There are six positions to be described ( fig.…”

XXXVI Surgical Decompression of the Recurrent Laryngeal Nerve in Idiopathic Unilateral Vocal Cord Paresis

“…A cord has never been observed to move to the cadaveric position from the mid line position. 1,3 New and Childrey stated that a cord fixed in the midline may recover and that a cadaveric cord may move to the midline. However, these authors did not distinguish between para median and cadaveric positions.…”