Minifenestration Type I Thyroplasty Using an Expanded Polytetrafluoroethylene Implant

Stasney, C. Richard; Beaver, Mary Es; Rodriguez, Margarita

doi:10.1016/s0892-1997(01)00015-7

Cited by 25 publications

(16 citation statements)

References 21 publications

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“…Similar to the outcome of Isshiki type I thyroplasty reported in previous studies 6, 22, 25, 32–34, 40 , inserting a thyroid cartilage graft implant for medialization improved MPT and voice parameters. Moreover, all patients exhibited an uneventful postoperative course without infection, tissue rejection, or graft dislocation.…”

Section: Discussionsupporting

confidence: 86%

Autologous thyroid cartilage graft implantation in medialization laryngoplasty: a modified approach for treating unilateral vocal fold paralysis

Tsai

Yang

Chang

et al. 2017

Sci Rep

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Medialization laryngoplasty is the standard surgical treatment for unilateral vocal fold paralysis. This study presents a modified approach in which a thyroid cartilage graft is implanted in medialization laryngoplasty. 22 patients who underwent this approach were included in the study. The results revealed that glottal incompetence and vocal performance were markedly improved following surgery, and the follow-up period ranged from 6 to 74 months (mean, 21.4 months). Acoustic analysis revealed significant improvements in the maximum phonation time (from 3.51 to 7.89 seconds, p < 0.001), F0 (from 221.7 to 171.0 Hertz, p = 0.025), and jitter (from 7.68 to 3.19, p < 0.001). Perceptual assessment revealed a significant decrease in voice grading (from 2.59 to 1.41, p < 0.001), roughness (from 1.82 to 1.23, p = 0.004), and voice breathiness (from 2.55 to 1.23, p < 0.001). None of the patients exhibited severe wound infection, tissue rejection, or other complications attributed to the surgical procedure. In conclusion, autologous thyroid cartilage implantation in medialization laryngoplasty medializes the vocal cord, minimizes the glottal gap, and improves the voice of patients with vocal fold paralysis. This procedure is characterized by simplicity, safety, and acceptable results.

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Section: Discussionsupporting

confidence: 86%

Autologous thyroid cartilage graft implantation in medialization laryngoplasty: a modified approach for treating unilateral vocal fold paralysis

Tsai

Yang

Chang

et al. 2017

Sci Rep

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“…6–9 Additionally softer materials including hand-carved silicone and layered Gortex are used. 10–13 The materials used for injection laryngoplasty include firm calcium hydroxylapatite and acellular dermis, and soft collagen and hyaluronic acid, and these also obviously vary in stiffness. 14–15 …”

Section: Introductionmentioning

confidence: 99%

Effects of Implant Stiffness, Shape, and Medialization Depth on the Acoustic Outcomes of Medialization Laryngoplasty

2015

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Objective Medialization laryngoplasty is commonly used to treat glottic insufficiency. In this study, we investigated the effects of implant stiffness (Young’s modulus), medialization depth, and implant medial surface shape on acoustic outcomes. Study Design Basic science study using ex vivo laryngeal phonation model. Methods In an ex vivo human larynx phonation model, bilateral medialization laryngoplasties were performed with implants of varying stiffness, medial surface shape (rectangular, divergent and convergent), and varying depths of medialization. The subglottal pressure, the flow rate, and the outside sound were measured as the implant parameters were varied. Results Medialization through the use of implants generally improved the harmonic-to-noise ratio (HNR) and the number of harmonics excited in the outside sound spectra. The degree of acoustic improvement depended on the implant insertion depth, stiffness, and to a lesser degree implant shape. Varying implant insertion depth led to large variations in phonation for stiff implants, but had much smaller effects for soft implants. Conclusions Implants with stiffness comparable to vocal folds provided more consistent improvement in acoustic outcomes across different implant conditions. Further investigations are required to better understand the underlying mechanisms.

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“…Since Isshiki et al (4) introduced the basic technique of thyroplasty, laryngeal framework surgery has been frequently used as a procedure for the management of incomplete glottal closure. Several modifications of Isshiki thyroplasty type I have subsequently been presented with the aim of optimizing the intra-operative surgical time, the positioning of the implant and the implant material itself such as Silasticie (5), hydroxilapatite (6, 7), Vitalium [miniplates] (8, 9), expanded polytetrafluoroethylene (Gore-Tex) (10, 11), and titanium implants (3, 12). The goal of the current study is to demonstrate the functional voice outcomes following external medialization thyroplasty using autologous cartilage from the nasal septum with the patient under local anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Medialization Thyroplasty Using Autologous Nasal Septal Cartilage for Treating Unilateral Vocal Fold Paralysis

Mesallam

Khalil

Malki

et al. 2011

Clin Exp Otorhinolaryngol

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ObjectivesA persistent insufficiency of glottal closure is mostly a consequence of impaired unilateral vocal fold movement. Functional surgical treatment is required because of the consequential voice, breathing and swallowing impairments. The goal of the study was to determine the functional voice outcomes after medialization thyroplasty with using autologous septal cartilage from the nose.MethodsExternal vocal fold medialization using autologous nasal septal cartilage was performed on 15 patients (6 females and 9 males; age range, 30 to 57 years). Detailed functional examinations were performed for all the patients before and after the surgery and this included perceptual voice assessment, laryngostroboscopic examination and acoustic voice analysis.ResultsAll the patients reported improvement of voice quality post-operatively. Laryngostroboscopy revealed almost complete glottal closure after surgery in the majority of patients. Acoustic and perceptual voice assessment showed significant improvement post-operatively.ConclusionMedialization thyroplasty using an autologous nasal septal cartilage implant offers good tissue tolerability and significant improvement of the subjective and objective functional voice outcomes.

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Minifenestration Type I Thyroplasty Using an Expanded Polytetrafluoroethylene Implant

Cited by 25 publications

References 21 publications

Autologous thyroid cartilage graft implantation in medialization laryngoplasty: a modified approach for treating unilateral vocal fold paralysis

Autologous thyroid cartilage graft implantation in medialization laryngoplasty: a modified approach for treating unilateral vocal fold paralysis

Effects of Implant Stiffness, Shape, and Medialization Depth on the Acoustic Outcomes of Medialization Laryngoplasty

Medialization Thyroplasty Using Autologous Nasal Septal Cartilage for Treating Unilateral Vocal Fold Paralysis

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