Clin Exp Otorhinolaryngol.  2011 Sep;4(3):142-148.

Medialization Thyroplasty Using Autologous Nasal Septal Cartilage for Treating Unilateral Vocal Fold Paralysis

• Mesallam T
• Khalil YA
• Malki KH
• Farahat M

Abstract

OBJECTIVES
A persistent insufficiency of glottal closure is mostly a consequence of impaired unilateral vocal fold movement. Functional surgical treatment is required because of the consequential voice, breathing and swallowing impairments. The goal of the study was to determine the functional voice outcomes after medialization thyroplasty with using autologous septal cartilage from the nose.
METHODS
External vocal fold medialization using autologous nasal septal cartilage was performed on 15 patients (6 females and 9 males; age range, 30 to 57 years). Detailed functional examinations were performed for all the patients before and after the surgery and this included perceptual voice assessment, laryngostroboscopic examination and acoustic voice analysis.
RESULTS
All the patients reported improvement of voice quality post-operatively. Laryngostroboscopy revealed almost complete glottal closure after surgery in the majority of patients. Acoustic and perceptual voice assessment showed significant improvement post-operatively.
CONCLUSION
Medialization thyroplasty using an autologous nasal septal cartilage implant offers good tissue tolerability and significant improvement of the subjective and objective functional voice outcomes.

Keyword

Unilateral vocal fold paralysis; Medialization thyroplasty; Autologous septal cartilage implant

MeSH Terms

Acoustics
Cartilage
Deglutition
Female
Humans
Laryngoplasty
Paralysis
Respiration
Vocal Cords
Voice
Voice Quality

Figure

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  Fig. 1 The cartilage window in the thyroid cartilage.

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  Fig. 2 The nasal septal cartilage after being removed. (A) The nasal septal cartilage as a whole and the rectangular shaped part of the cartilage to be placed in the window. (B) Two chips of the nasal septal cartilage that are used in medialization.

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  Fig. 3 Pre-operative laryngoscopic assessment of a patient with right vocal fold paralysis and a total glottis gap.

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  Fig. 4 Post-operative laryngoscopic assessment of a patient with right vocal fold paralysis and almost complete glottis closure.

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  Fig. 5 Post-operative laryngoscopic assessment of a patient with right vocal fold paralysis and a posterior glottis gap.

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