A 40-year-old woman develops progressive bilateral vocal cord palsy after total thyroidectomy. She develops stridor at rest. Her preferred treatment for airway restoration while preserving voice quality is:
- A Lateralization of one vocal cord (cordopexy/cordotomy) via endoscopic approach ✓
- B Emergency tracheostomy as definitive treatment
- C Total arytenoidectomy of both arytenoids
- D Permanent tracheostomy and speech therapy
Correct answer: A. Lateralization of one vocal cord (cordopexy/cordotomy) via endoscopic approach
Explanation
For bilateral vocal cord palsy with stridor, endoscopic posterior cordotomy or cordopexy (lateral fixation of one vocal cord) provides adequate airway by enlarging the posterior glottis, while preserving reasonable voice quality. Tracheostomy provides immediate airway but is not a voice-preserving definitive option. Total bilateral arytenoidectomy is reserved for severe cases and causes significant voice deterioration. Unilateral procedures optimally balance airway and voice.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.