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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.

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
Thyroplasty type I under general anesthesia with the use of the laryngeal mask and a waking period to assess voice RSS Download PDF · Eleanor Sproson · , Jeremy Nightingale · and Roberto Puxeddu Auris Nasus Larynx, 2010-06-01, Volume 37, Issue 3, Pages 357-360, Copyright © 2009 Elsevier Ireland Ltd A series of thyroplasty cases under general anaesthesia I. Razzaq, W. Wooldridge BJA: British Journal of Anaesthesia, Volume 85, Issue 4, 1 October 2000, Pages 547–549, https://doi.org/10.1093/bja/85.4.547 Published: 01 October 2000 General anaesthesia for thyroplasty M. Griffin, J. Russell, F. Chambers First published: 06 April 2002 https://doi.org/10.1046/j.1365-2044.1998.00609.x Citations: 9 Dr Micheal Griffin Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8051, USA

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