Unilateral Endoscopic Laser Medial Arytenoidectomy in Transient Bilateral Palsy of the Recurrent Laryngeal Nerve after Thyroid Surgery: Is it Worth the Candle?

During the acute phase of transient bilateral paralysis after thyroid surgery, a tracheotomy unfortunately remains the solution in most emergency situations. The author describes and discusses the case of a totally thyroidectomized female patient, who presented fifteen days after surgery with bilateral vocal cord paralysis resulting in dyspnea and exhaustion. After tracheotomy refusal, a unilateral endoscopic laser medial arytenoidectomy was performed that enabled the patient to lead a normal daily life without dysphonia. Bilateral vocal cord mobility recovered slowly but completely. This is the first and only case of this procedure during the acute phase of bilateral vocal cord paralysis reported in the literature. The benefits versus the risks are discussed.