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November 1988

Surgical Correction of Dysphonia due to Bowing of the Vocal Cords

Author Affiliations

Mobile, Ala

Arch Otolaryngol Head Neck Surg. 1988;114(11):1231. doi:10.1001/archotol.1988.01860230025013

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Dr James Koufman, Winston Salem, NC, at the Annual Meeting of the American Laryngological Association in Palm Beach, Fla, reported his experience with laryngoplastic surgical correction of dysphonia associated with bowing of the vocal cords. Dr Koufman reviewed the four major laryngoplasty techniques that have been used for the treatment of bowing of the vocal cords by lengthening and, thus, tightening the vocal ligaments. Koufman's technique is based on the anatomy of Broyle's ligament, which relates to the attachment of the vocal cords at the anterior commissure. Koufman's innovative modification provides for advancement of Broyle's ligament by using a superiorly based flap. This causes less mechanical disruption of Broyle's ligament. The vocal cords are then extended toward the medial aspect by the placement of Silastic implants to augment the lateral aspects of the larynx and vocal cords. These spaces occupying Silastic grafts allow the vocal cords to remain in the

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