Abstract
A novel technique of thyroplasty—Sandwich thyroplasty—described, with modification of Isshiki’s thyroplasty window to overcome the problems of securing and stabilising the silicone implant in the window thus simplifying the medialization of the vocal fold. Seventy five patients diagnosed with paralytic dysphonia of varied etiology, attending Sri Sathya Sai Institute of ORL, Guntur, India from January 2005 to January 2012, were subjected to this new technique. Medialization of vocal fold was achieved by sandwiching and stabilising a silicone implant between a superiorly based cartilaginous hinged door and the inner perichondrium of the modified thyroplasty window. Results were analysed based upon pre and postoperative voice handicap index, maximum phonation time readings and video-stroboscopic findings. The results were statistically significant with no untoward complications. Sandwich thyroplasty technique facilitated easier fixation and stabilization of silicone implant avoiding difficult and time consuming, techniques involving flanges or sutures.
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Abbreviations
- ML:
-
Medialization laryngoplasty: Type-1 thyrodplasty
- AAT:
-
Arytenoid adduction technique
- VHI:
-
Voice handicap index
- MPT:
-
Maximum phonation time
- GRABS:
-
Grading of roughness, asethenic, breathy, strained
- H&N ratio:
-
Harmonic to noise ratio
- PDA:
-
Patent ductus arteriosus
References
Isshiki N, Morita H, Okamura H, Hiramoto (1974) Thyroplasty as a new phonosurgical technique. Acta Otolaryngol 78:451–457
Koufman JA, Isaacson G (1991) Laryngoplastic phonosurgery. Otolaryngol Clin North Am 24:1151–1171
Friedrich G (1998) (External vocal fold medialization: surgical experiences and modifications. Laryngorhinootologie 77(1):7–17
Cummings CW, Purcell LL, Flint PW (1993) Hydroxylapatite laryngeal implants for medialization: preliminary report. Ann Otol Rhinol Laryngol 102:843–851
Desrosiers M, Ahmarani C, Bettez M (1993) Precise vocal cord medialization using an adjustable laryngeal implant: a preliminary study. Otolaryngol Head Neck Surg 109:1014–1019
McCulloch TM, Hoffman HT (1998) Medialization laryngoplasty with expanded polytetrafluoroethylene, surgical technique and preliminary results. Ann Otol Rhinol Laryngol. 107:427–432
Montgomery WW, Blaugrund SM, Varvares MA (1993) Thyroplasty: a new approach. Ann Otol Rhinol Laryngol 102:571–579
Fredrique G (1999) Titanum vocal fold medializing implant: introducing a novel implant system for external vocal fold medialization. Ann Otol Rhinol Laryngol 108:79–86
Bielamowicz S (2004) Medialization laryngoplasty technique. Otolaryngol Clin North Am 37:139–160
Mahieu Hans F (2006) Practical applications of laryngeal framework surgery. Otolaryngol Clin North Am 39:55–75
Hunsaker Darrell H, Martin Peter J (1995) Allergic reaction to solid silicone implant in medial thyroplasty. Otolaryngol Head and Neck Surg 113:782–784
Kartha S, Young K, Mohan S (2011) Complications of medialization laryngolplasty (thyroplasty type-I). Int J Phonosurg Laryngol 1:1–3
Cotter CS, Avidano MA, Crary MA, Cassisi NJ, Gorham MM (1995) Laryngeal complications after type 1 thyroplasty. Otolaryngol Head Neck Surg 113:671–673
Ford Charles N, Bless Diane M, Prehn Robert B (1992) Thyroplasty as primary and adjunctive treatment of glottic insufficiency. J Voice 6:277–285
Kydd William L, Wayne Neff C (1964) Frequency of deglutition of tongue thrusters compared to a sample population. J Dent Res 43:3
Jacobson BH, Johnson A, Grywalski C, Cilbergleit A, Jacobson G, Benninger MS (1997) The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol 6:66–70
Lundy DS, Casiano RR, Xue JW (2004) Can maximum phonation time predict voice outcome after thyroplasty type I. Laryngoscope 114:1447–1454
Woo Peak (2000) Arytenoid adduction and medialization laryngoplasty, voice disorders and phonosurgery 1. Otolaryngol Clin North Am 33:817–839
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Phaniendrakumar, V., Chaitanya, C.B., Ravindranath, T.A. et al. Sandwich Thyroplasty: A Novel Technique for Simplifying Medialization of Vocal Fold Using Silicone Implant in Paralytic Dysphonia with Modification of Thyroplasty Window. Indian J Otolaryngol Head Neck Surg 67, 159–164 (2015). https://doi.org/10.1007/s12070-014-0761-z
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DOI: https://doi.org/10.1007/s12070-014-0761-z