Medialization Thyroplasty with a Customized Silicone Implant: Clinical Experience

Abstract

The authors implemented medialization thyroplasty with a customized silicone implant in a total of 43 operations (36 patients) in 1999–2003. In 5 of these patients, the medialization thyroplasty was combined with cricothyroid subluxation (3 cases) or adduction of arytenoid cartilage (3 cases). One patient received medialization thyroplasty, cricothyroid subluxation and adduction of arytenoid cartilage. Postoperatively 36 patients reported substantial reduction of their complaints, 5 patients found their voice improved and only 2 patients (5.6%) stated that their voice had not changed. The subjective evaluation was consistent with the findings of laryngoscopy and the preoperative and postoperative phonation parameters (maximum phonation time, maximum sound pressure level, jitter and shimmer). Average maximum phonation time was 6.5 s before surgery and 12.5 s after surgery. Maximum vocal sound pressure level was, on average, about 4 dB higher after surgery. Jitter was reduced from 5.3 to 3.7% and shimmer from 32.3 to 18.6%. The differences between presurgical and postsurgical parameters in our study were all statistically significant, indicating voice improvement. Medialization thyroplasty with a silicone implant was proven to be a successful and safe surgical method for the treatment of vocal fold paralysis.

A Meta‐analysis of Voice Outcome Comparing Calcium Hydroxylapatite Injection Laryngoplasty to Silicone Thyroplasty

“…Twenty-four studies satisfied the inclusion criteria. 6,11-35 Data were first summarized according to the types of intervention and the types of outcome measures. Then the quality of the measurement methods was evaluated, in addition to patient recruitment, data replicability, and missing data.…”

“…After initial screening, 71 articles were deemed relevant. Twenty‐four studies satisfied the inclusion criteria 6,11–35 . Data were first summarized according to the types of intervention and the types of outcome measures.…”

Medialization Thyroplasty Using the Pocket and Silicone Implant Technique

“…4 A study by Chrobok, et al evaluating the use of customized silicone implant in medialization thyroplasty concluded that successful and safe medialization thyroplasty using a silicone implant is possible based on improvement of maximum vocal sound pressure level, phonation time, and jitter and shimmer reduction. 6 A review of MEDLINE (PubMed), EMBASE and HERDIN using the keywords "unilateral vocal cord paralysis; medialization thyroplasty; Isshiki thyroplasty; silicone implant" did not reveal a technique similar to our pocket and silicone implant method.…”

Glottal Function Index and GRBAS Scale of Patients Undergoing Vocal Cord Medialization: A Series of Five Patients

“…6 Medialization thyroplasty using soft silicone implants has been shown to be safe and effective. 7 Although the use of titanium implants have been shown to provide superior voice quality outcomes, the difference compared to soft silicone implants was insignificant. 8 Complications ranging from implant extrusion to airway compromise are low as shown in our patients, reflecting other studies.…”