We performed arytenoidectomies under microlaryngoscopy in three cases, two males and one female, suffering from severe dyspnea secondary to vocal cord paralysis. In all three cases, a tracheostomy was made prior to the surgery. In two of the cases, bilateral paralysis of the vocal cords was found, while the other case showed a narrow glottis with left vocal cord paralysis and a twisted larynx from the thyroid carcinoma. After arytenoidectomy, the dyspnea was improved in all three cases, and the tracheostoma was closed in the former two cases. Although several surgical techniques have been reported for patients with narrow glottis, most of them present some technical difficulties. A microlaryngoscopic approach for arytenoidectomy requires no incision, and the technique is relatively easy compared to other methods and useful for the treatment of dyspnea due to vocal cord paralysis.