Among various surgical techniques of arytenoid adduction, lateral cricoarytenoid muscle (LCA) pull operation has been newly developed as a further improved treatment of choice for one-vocal-fold paralysis. This operation has been conducted under a local anesthetic condition through a 10mm×8 mm thyroplasty window created just anterior to the oblique line and 7 mm to 8 mm cranial to the lower edge of the thyroid cartilage. In the window, several pices of 4-0 Ti-cron stiches are passed and tied securely at different points of the atrophic LCA bundle. Those threads then are fixed anteriorly and inferiorly to the thyroid cartilage. Direction as well as strength of the threads on the thyroid cartilage are all decided with reference to intra-operative voice improvement of individual patients. A total of 38 patients with one-vocal-fold paralysis underwent LCA pull operation over the periods of 1987 through 1994. In 32 of the cases (84.2%), vocal-fold fixation occurred at the intermediate position preoperatively. In the other 5 cases (13.2%), it occurred at the paramedian position preoperatively. The remaining one case showed median fixation of a vocal fold yet to present weaker and diplophonic voice preoperatively. All the patients had complained not only of marked breathy voice, aphonia, weaker voice or diplophonia but also of intermittent aspiration preoperatively. LCA pull operation outcome:1. Successful medialization of the vocal fold resulted in 90.6%.2. Normal thickness of the vocal fold resulted in 92.3%.3. Straight status of the vocal fold from the preoperatively bowed status resulted in 86.7%.4. Successful adjustment of vocal-fold level difference resulted in 75%.5. Extension of maximum phonation time exceeding 5 seconds up to 30 seconds resulted in 68.4%.6. Clearer, volumef ul non-breathy voice resulted in 75.8%.7. Successful elimination of diplophonia resulted in 93.5%.8. Louder voice instead of weaker voice resulted in 78.9%.9. Resolution of aspiration problem resulted in 88.5%.10. None of the cases showed postoperative air-way problems.