A case of high-pitched diplophonia that resolved after a direct pull of the lateral cricoarytenoid muscle

TLDR

Unilateral vocal cord paralysis has been treated with various surgical approaches, and this case involved a patient with cerebellum/brainstem inflammation diagnosed in 2002. The 66‑year‑old patient underwent a direct pull of the lateral cricoarytenoid muscle in October 2002. The procedure resolved high‑pitch diplophonia, restored favorable mucosal waves, and proved effective even in mild unilateral vocal cord paralysis.

Abstract

Various approaches have been employed for the surgical treatment of unilateral vocal cord paralysis. Recently, we performed a direct pull of the lateral cricoarytenoid muscle in a case of high-pitched diplophonia with little difference between the right and left vocal cord levels and obtained favorable results. The patient was a 66-year-old male who consulted our hospital with chief complaints of husky voice and abnormal sensation in the pharyngolaryngeal region. Cerebellum/brainstem inflammation was diagnosed in February 2002 and appropriate treatment was instituted. Despite an improvement in the patient's systemic condition, right vocal cord paralysis remained. Although there were no abnormalities in the vocal range for ordinary speech, diplophonia was noted at high pitches, and synchronization could not be observed using stroboscopy. Therefore, the patient was operated on in October 2002. The high-pitched diplophonia disappeared and stroboscopy revealed favorable mucosal waves at high pitches. Thus, direct pulling of the lateral cricoarytenoid muscle appears to be a useful procedure, even in a case of mild unilateral vocal cord paralysis.