LARYNGEAL REBALANCING FOR THE TREATMENT OF ARYTENOID DISLOCATION

In almost every type of functional laryngeal operation a successful re sult hinges on the surgeon's ability to control the muscular and ligam entous forces that act upon the vocal folds. Most of the time these fo rces are small in relation to the manipulations and resections perform ed. Occasionally, the forces are significant relative to the problem e ncountered, resulting in a failed surgery. Of all the many conditions that fit in to this latter description, perhaps the best example in ar ytenoid dislocation. Dislocation of the arytenoid is usually secondary to trauma with the majority of reported cases resulting from some typ e of anesthetic misadventure. Two types of dislocation have been descr ibed, anteromedial and posterolateral, each with a different mechanism of causation. This paper concerns itself with the more common anterom edial variety and its treatment using botulinum toxin.