Laryngeal immobility following thyroid surgery.

One of the most common complications of surgery of the thyroid gland is voc al folds immobility. New advances in its management have been achieved over the last few years. Laryngeal electromyography, stroboscopy, and computeri zed analysis of the voice help guide diagnosis, allowing differentiation be tween recurrent nerve paralysis and glottis traumatism due to intubation, a nd further follow-up of recovery with relevant therapeutic decisions. In ca se of unilateral Vocal fold paralysis, intrafold silicone or injection of a utologous fat is more and more routinely used to obtain vocal rehabilitatio n. In case of bilateral Vocal fold paralysis, to avoid tracheotomy, partial posterior cordectomy using laser surgery restores sufficient laryngeal air flow, with minimal vocal sequelae. Early management of these complications by teams of specialists should allo w appropriate and less invasive surgery. (C) 2001 Editions scientifiques et medicales Elsevier SAS.