Introduction: Bilateral vocal fold paralysis (BVFP) is a complicated life-threatening clinical problem. Airway enlargement procedures for bilateral vocal fold immobility, such as cordotomy and arytenoidectomy, permanently impair voice and increase the risk of aspiration. An innovative strategy for restoring ventilation without affecting voice or swallowing is botulinum toxin injection into the thyroarytenoid muscle.
Objective: To investigate the effectiveness of thyroarytenoid muscle chemical denervation with botulinum toxin injection in diminishing dyspnea in BVFP by changing the positioning of the paralyzed VFs.
Patients and Methods: 12 patients suffering from bilateral vocal folds immobility were enrolled in the study. Botulinum toxin injection was performed into each vocal fold via a per-oral approach. Voice evaluation, laryngoscopic examination, and pulmonary function tests were carried out before and 15 days after the injection.
Results: All patients reported improvement of their respiratory symptoms as well as improvement of the pulmonary function studies following the injection. Patients who received repeated injections demonstrated a longer duration of symptoms improvement. Voice handicap index scores were not significantly changed after botulinum toxin injection into each vocal fold.
Conclusion: Botulinum toxin injection is a less invasive, short term treatment option improving ventilation in patients with BFVP with little or no effect on voice or swallowing.