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This collection contains 18 articles pertaining to Bilateral Vocal Fold Immobility (BVFI). Most of the papers deal with the etiology and treatment of BVFI.
The more common causes of BVFI are addressed in a review article in 2003 (1), in which the authors point out evolving trends. Most cases are caused by malignancies and nonsurgical trauma, followed by iatrogenic causes such as thyroid surgery. There are several interesting reports detailing unusual etiologies of BVFI, including intubation, sarcoidosis, acromegaly, Creutzfeld-Jacob disease and laryngeal chondrosarcoma.
Many of the articles relating to management focus on surgical options intended to allow for decannulation, a good airway, a serviceable voice, and safe degluttition. Endoscopic posterior cordotomy/cordectomy is discussed, either alone or in combination with some form of arytenoidectomy. Endoscopic suture lateralization also has been proposed as a procedure which allows for adjustments and is ultimately reversible. Laryngeal reinnervation has been suggested as a means of treatment, although it is not yet used commonly. Botulinum toxin injection into the thyroarytenoid or cricothyroid muscles has been described, achieving sufficient vocal fold abduction to produce decannulation. These injections may be used as a temporizing solution until a more permanent intervention is planned, or they may be repeated regularly for maintenance of effect.
In summary, this collection provides interesting insights into the etiology and treatment of BVFI offering an appreciation of possible future directions.