Development of Laryngeal Framework Surgeries for the Treatment of Breathy Hoarseness due to Unilateral Vocal Fold Paralysis

The author reviewed the development of laryngeal framework surgeries for the treatment of severe hoarseness due to unilateral vocal fold paralysis. The improvement of breathy hoarseness after surgery is usually archieved by various types of framework surgery, including intracordal injection, type I thyroplasty, arytenoid adduction, and their modifications. However, a significant number of patients do not recover their “normal” voices after surgery. It is hoped that laryngologists will develop a novel method through which such patients can recover their “normal” voices. Such a method should be able to give the immobile vocal fold median location, as well as volume and mucosal viscoelasticity symmetrical with those of the unaffected vocal folds. The author believes that arytenoid adduction combined with a type of reinnervation technique will satisfy these requirements.