Combined Technique: Medialization and Tension Adjustment

Abstract

The preoperative manual test is capable of predicting to some extent the outcome of surgery. The intraoperative manual test provides a more reliable guide to the mechanical changes of the vocal cord possible from surgery. After tentative medialization of the vocal cord without fixing the window in depression, noninvasive manual slackening or tightening of the vocal cords should always be attempted prior to the surgical procedure to observe any change in voice quality. This test is especially important when the voice is not satisfactory at this stage or the patient complains of some strain on vocie production.