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The majority (76.6%) of BVFP cases are iatrogenic. BVFP requires immediate tracheotomy in 36.2% of cases. Laterofixation of the vocal fold was described in 9 studies and is a cost\u2010effective alternative procedure to tracheotomy while awaiting potential recovery. Unilateral and bilateral posterior transverse cordotomy outcomes were reported in 9 and 7 studies, respectively. Both approaches are associated with a 95.1% decannulation rate, adequate airway volume, but voice quality worsening. Unilateral\/bilateral partial arytenoidectomy data were described in 4 studies, which reported lower decannulation rate (83%) and better voice quality outcome than cordotomy. Revision rates and complications vary across studies, with complications mainly involving edema, granuloma, fibrosis, and scarring. Selective posterior cricoarytenoid reinnervation is being performed by more surgeons and should be a promising addition to the BVFP surgical armamentarium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Depending on techniques, the management of BVFP may be associated with several degrees of airway improvements while worsened or unchanged voice quality. The heterogeneity between studies, the lack of large\u2010cohort controlled randomized studies and the confusion with posterior glottic stenosis limit the draw of clear conclusion about the superiority of some techniques over others.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.616","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T23:00:17Z","timestamp":1703113217000},"page":"724-735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Management of Bilateral Vocal Fold Paralysis: A Systematic Review"],"prefix":"10.1002","volume":"170","author":[{"given":"J\u00e9r\u00f4me R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Elsan Hospital Paris France"},{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Foch Hospital, School of Medicine, UFR Simone Veil Universit\u00e9 Versailles 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