Unilateral vocal cord paralysis usually results from thyroid operation, cervical disc operation or esophageal surgery. Paralyzed vocal cord stays off the midline in the larynx and healthy vocal cord cannot touch it during phonation. Voice is weak and scratchy. The patient is breathless during speech. People can hardly hear him. He gets very tired during speaking. The most commonly performed operation for unilateral vocal cord paralysis is thyroplasty type 1. A silicon block is placed lateral to paralyzed vocal cord to make it touch the healthy vocal cord during speaking. That is how voice is improved after thyroplasty. If the gap between vocal cords is too large, silicon cannot close this gap and adduction arytenopexy procedure has to be added to thyroplasty. In order to tighten the flaccid paralyzed vocal cord cricothyroid luxation is added to the procedure. This increases the strength of voice further. It is an open surgery, it requires an external neck skin incision. The patient is hospitalized for 2 days after operation in order to take care of the wound.

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