Preliminary investigation of adjustable balloon implant for type I thyroplasty

Abstract

Objective-We present the adjustable balloon implant (ABI), a novel implant to be used in type I thyroplasty for the treatment of vocal fold paralysis. The ABI offers the same medialization provided by other implants, but can easily be catered to individual patient anatomy as well as modified postoperatively without the need for a revision thyroplasty. Study design-Repeated measures with each larynx serving as its own control.Methods-Medialization thyroplasty (MT) with the ABI was performed on five excised canine larynges. Mucosal wave, aerodynamic, and acoustic parameters were measured for three conditions: normal; right vocal fold paralysis; and paralysis with the ABI.Results-Insertion of the ABI resulted in significant decreases in both phonation threshold pressure and phonation threshold flow. Perturbation parameters of percent jitter and percent shimmer were also significantly decreased and restored to normal levels. Signal-to-noise ratio was significantly increased to the normal level as well. The mucosal wave was preserved after implant insertion.Conclusions-This preliminary experiment showing significant improvements in aerodynamic and acoustic parameters demonstrates the potential of the ABI as a thyroplasty implant. Effective medialization and preservation of the mucosal wave combined with post-operative adjustability makes it a potentially valuable clinical device.

Excised larynx evaluation of wedge‐shaped adjustable balloon implant for minimally invasive type I thyroplasty

“…Additionally, based on PTF values that more closely match those of the normal condition, the wABI provided improved closure of the posterior glottis. This is in contrast to our initial spherical implant, which exhibited PTF values greater than the normal condition …”

Using peak direct subglottic pressure level as an objective measure during medialization thyroplasty: a prospective study

“…In our most recent published experience [16], the revision rate was 7 % and revision rates reported in the [18] and the only objective parameter reported in the literature is MPT because of its ease to obtain as it only requires a stop watch [12]. Zpater et al [19] introduced new measuring devices to achieve more accurate placement of the implant during MT although not solving the problem of incorrect implant size.…”

Objective measurement of real time subglottic pressure during medialization thyroplasty: a feasibility study

“…Hoffman et al [13] recently published a study on an adjustable balloon implant (ABI) for type I thyroplasty that was explored on excised canine larynges on an experimental bench. The ABI is a silicone balloon that can be filled with saline after it is introduced into the larynx via a standard thyroplasty window and stabilized with a metal frame.…”