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February 1989

Surgical Correction of Dysphonia due to Bowing of the Vocal Cords

Author Affiliations

Mobile, Ala

Arch Otolaryngol Head Neck Surg. 1989;115(2):141. doi:10.1001/archotol.1989.01860260015006

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James Koufman, MD, Bowman Gray School of Medicine, Winston Salem, NC, reported his experience with laryngoplastic surgical correction of dysphonia associated with bowing of the vocal cords at the 109th annual meeting of the American Laryngological Association, Palm Beach, Fla. Koufman reviewed the four major laryngoplasty techniques utilized for treatment of bowing of 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, using a superiorly based flap. This causes less mechanical disruption of Broyle's ligament. The vocal cords are then medialized by the placement of Silastic implants to augment the lateral aspects of the larynx and vocal cords. These space-occupying Silastic grafts provide a permanent degree of medialization of the vocal cords. The technique can be carried

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