Abstract
Bilateral vocal fold immobility can be a life-threatening condition. The immobile vocal folds obstruct the airway and cause stridor or dyspnea, compared to complaints limited to the voice with unilateral vocal fold immobility. Bilateral vocal fold paralysis implies loss of innervation from the recurrent laryngeal nerves bilaterally. In contrast, posterior glottic stenosis implies fixation due to scar or joint ankylosis. Laryngeal electromyography can objectively determine if there is altered innervation and can be helpful prognostically as well. Imaging of the length of the bilateral vagus or recurrent laryngeal nerves is sometimes indicated and usually performed with CT or MRI; a single causative lesion must be large enough to affect both RLNs, both arytenoids, or both nucleus ambiguus in the medulla.
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Matrka, L., Morell, F.J. (2019). Diagnostic Studies in Work-Up for Bilateral Vocal Fold Paralysis: When and Why. In: Amin, M., Johns, M. (eds) Decision Making in Vocal Fold Paralysis. Springer, Cham. https://doi.org/10.1007/978-3-030-23475-1_14
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