Bilateral vocal cord palsy due to a lesion of the recurrent laryngeal nerves is a serious complication of thyroid operations, with the airway obstruction usually necessitating tracheostomy. In the cases presented, a stable airway was ensured with endolaryngeal cord laterofixation instead of tracheostomy. The operation was performed with the endo-extralaryngeal needle carrier instrument devised by Lichtenberger. During the operation, only minor surgical trauma occurred in the larynx. The fixing thread was then removed following recovery of contralateral vocal cord function, resulting in an improvement in the voice. Four patients are described who suffered bilateral recurrent laryngeal nerve palsy after thyroid gland operations. During the follow-up period of 3-12 months, airway stability was demonstrated by regular spirometric measurements. The simple method recommended spares patients the possible complications of tracheostomy.