Medialization Thyroplasty A continuous endoscopic viewing under 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, 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.

Pediatric Tracheostomy

Paediatric Tracheostomy

Position the child with chin extension appropriately
Drape the child as shown in the video
Mark the incision line
Use 15 number blade for skin incision
Remove the excessive subcutaneous fat tissue
Find the median raphe and strap muscles
Retract the strap muscles laterally
Identify the tracheal ring
Create the impression of tube for appropriate size incision
Place the stay sutures as shown in the video
incise the trachea with 11 number blade
Secure the maturation sutures
Insert the tracheostomy tube
Confirm the position and then inflate the cuff
Secure the ties and dressing at the end.

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