Medialization thyroplasty is used for the management of vocal fold paralysis. During this procedure, a prosthesis is placed lateral to the inner perichondrium of the thyroid lamina. The structural integrity of the vocal fold is preserved with effective closure of the pre-phonatory gap, the result being vocal efficiency.
In our series of 4 patients in the last 1 year, we tried a new method of anesthesia which enabled us to get a view of vocal cords during the entire surgery and hence helped us in gauging the extent and the level of medialization during the procedure.
This procedure may be advocated in cases where we feel the patient may not cooperate with local anesthesia and a general anesthesia would result in medialisation being done without the view of the endolarynx, resulting in suboptimal results.
In our series of 4 patients in the last 1 year, we tried a new method of anesthesia which enabled us to get a view of vocal cords during the entire surgery and hence helped us in gauging the extent and the level of medialization during the procedure.
This procedure may be advocated in cases where we feel the patient may not cooperate with local anesthesia and a general anesthesia would result in medialisation being done without the view of the endolarynx, resulting in suboptimal results
Cricothyroid joint fixation
Sulcus vocalis
Soft tissue defects from excision of pathologic tissue
Aspiration or severe dysphonia as an alternative to repeated vocal fold injections
Patients who are cooperative enough to get procedure done under local anaesthesia
Genreral OT
LMA
Flexible bronchoscope
Routine investigations for general anaesthesia
Medialization thyroplasty is used for the management of vocal fold paralysis. During this procedure, a prosthesis is placed lateral to the inner perichondrium of the thyroid lamina. The structural integrity of the vocal fold is preserved with effective closure of the pre-phonatory gap, resulting in vocal efficiency.
Advantages
Dynamic and can check phonation during graft insertion
Lower consumables
Lower cost
Disadvantages
Discomfort to the patient
Apnea
Stridor
Hypoxia
May require bigger incision
Existing comorbidities
Risks are those associated with general anesthesia depending on co-morbidities of the patient
None
Dr. Shalina Ray
Consultant Dept of Oto-Rhino- Laryngology
Manipal Hospital Bangalore
Dr. Girish Rai
Consultant Dept of Oto-Rhino- Laryngology
Manipal Hospital Bangalore
Review Medialization Thyroplasty A continuous endoscopic viewing under General anaesthesia. Cancel reply
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Review Medialization Thyroplasty A continuous endoscopic viewing under General anaesthesia.