Surgery for Vocal Fold Immobility

Patients with unilateral vocal fold paralysis (UVFP) will typically present to the clinic with a breathy, quiet, and high-pitched voice. Poor vocal fold closure on phonation leads to glottic insufficiency, and hence the loss of air and a breathy quality. The high pitch of the voice is a function of a compensatory technique employed instinctively by most patients: By tensioning the vocal folds, better closure can be achieved, but this tension results in a raised phonatory pitch. Patients also frequently complain of a subjective sensation of breathlessness; in fact, this is not genuine dyspnoea, but with the incompetence of the glottis and excessive air loss, the patient perceives shortness of breath.