In presenting a new operation for the relief of bilateral cord paralysis, it seems fitting first to discuss the general principles involved in operations previously done for that purpose. All previous attempts to relieve the condition can be classified under four general headings.
This discussion is limited to a consideration of those bilateral recurrent nerve paralyses which follow operations for goiter. I have made no study of postdiphtheritic paralyses or those that occur as a part of the picture of progressive bulbar paralysis.
Permanent tracheotomy with insertion of a tube or with suture of the skin to the incised edges of the trachea so as to leave a permanent opening.
Nerve suture. The following nerves have been anastomosed to the distal portion of the injured recurrent nerve: (a) the proximal portion of the recurrent nerve, (b) the descendens noni, (c) the roots of the spinal accessory nerve and