Objective: Establish, through the determination of the glottic angle and area, a decision regarding safe and necessary interventions in bilateral vocal fold paralysis to maintain airway. Methods: From January 2008 to December 2023, we looked back at laryngoscopic photographs of subjects with bilateral vocal fold paralysis. The average vocal fold length for each gender was used to calculate the glottic areas and measure the corresponding glottic angles in a total of 26 cases. In order to determine the angles between the anterior commissure and each vocal process, 2 clinicians separately measured the lines and took their average measurement. The average vocal cord length by gender in the Taiwanese data was used to compute the glottic area. Results: The results showed the average glottic angle was 10.3° ± 7.3°. The intervention group (N = 17) had an average glottic angle of 7.1° ± 3.7°. The nonintervention group (N = 9) had an average glottic angle of 16.3° ± 8.9°. The average glottic area was 18.7 ± 10.2 mm2, with 14.2 ± 7.5 mm2 in the intervention group and 27.2 ± 9. 4 mm2 in the nonintervention group. Conclusion: We concluded that emergent airway intervention including intubation or tracheostomy was suggested when the glottic angle <12.2° or glottic area <25.2 mm2.
Keywords: glottic angle; glottic area; secure airway; vocal cord palsy; vocal cord paralysis.