BILATERAL MEDIALIZATION LARYNGOPLASTY

Objectives: To present indications, techniques, and results of bilater al medialization laryngoplasty (BML). Study Design: Retrospective revi ew of 39 consecutive patients who had BML for correction of glottal in sufficiency attributable to presbylaryngis (n = 16), bilateral vocal f old paresis (n = 13), unilateral paralysis with contralateral bowing ( n = 4), and other miscellaneous neurologic diseases (n = 6), Methods: Complete preoperative and postoperative clinical and acoustical data w ere analyzed for 74% (29/39) of the subjects. All 39 subjects complete d a patient survey to assess their long-term outcomes. Results: Overal l, 90% (35/39) of the patients who had BML experienced significant imp rovement in voice and swallowing function. Subsequently, 36% (14/39) o f the patients underwent adjunctive lipoinjection for closure of small residual glottal gaps (vocal ''fine-tuning''). Of the BML patients (w ith or without lipoinjection) who had complete preoperative and postop erative voice data, 83% (24/29) had complete glottal closure after sur gery, resulting in normal or near-normal voices, Eighty-five percent ( 33/39) of the patients responded that they ''would have surgery again. '' Of the six patients who said that they would not have surgery again , three had good results and one had progressive neurologic disease. T he mean duration of follow-up was 17 months. Conclusions: BML is an ef fective rehabilitative surgical treatment for symptomatic vocal fold b owing. In addition, lipoinjection is useful as an adjunct to BML to en hance the voice outcome in selected cases.