Matsushima K, et al. - In this retrospective study, researchers presented the clinical findings of 10 cases of bilateral vocal fold immobility (adducted type) and suggested potential treatment options. The sample consisted of 10 patients who had tracheostomy for restricted airway due to bilateral vocal fold immobility of the adducted type during the period from 2007 to 2017. Based on the clinical results in these 10 cases of bilateral vocal fold immobility of the adducted type, treatment options are recommended and a severity classification system of bilateral vocal fold immobility is proposed that concentrates mainly on electromyography results for dynamic restenosis assessment and traction-mobility test results for static restenosis assessment. In a larger cohort of cases of bilateral vocal fold immobility, validation of the classification system is required.