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Sandwich Thyroplasty: A Novel Technique for Simplifying Medialization of Vocal Fold Using Silicone Implant in Paralytic Dysphonia with Modification of Thyroplasty Window

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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

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Conflict of interest

The authors declare no conflict of interest in the submission of this manscript.

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Authors and Affiliations

  1. Sri Sathya Sai Institute of ORL and Research Centre for Voice Disorders, 4/2, Brodiepet, Guntur, 522002, Andhra Pradesh, India

    V. Phaniendrakumar, C. Bharadwaj Chaitanya, T. Are. Ravindranath & R. Sirisha

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  1. V. Phaniendrakumar
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  2. C. Bharadwaj Chaitanya
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  3. T. Are. Ravindranath
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  4. R. Sirisha
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Correspondence to V. Phaniendrakumar.

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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

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