Thyroplasty

Overview  

Medialization laryngoplasty, formerly known as thyroplasty, is a surgical procedure designed to treat vocal cord paralysis. In this procedure, a surgeon inserts an implant into the paralyzed or weakened vocal cord. The purpose of the implant is to reposition the nonfunctioning vocal cord closer to the functioning one, enabling better voice production. This condition affects the larynx, or voice box, which houses two vocal cords that help regulate breathing, speaking, and swallowing by vibrating as air passes through them. 

Unilateral vocal cord paralysis occurs when one vocal cord loses its ability to move or becomes significantly weakened. This leads to difficulties in producing sound, as one vocal cord cannot vibrate in sync with the other. Though rare, some cases involve bilateral vocal cord paralysis, where both vocal cords are affected. This condition can be life-threatening and requires prompt and specialized care from an ear, nose, and throat (ENT) surgeon. 

Common symptoms of vocal cord paralysis include chronic coughing, hoarseness, and frequent throat clearing. People with this condition may also experience difficulty swallowing, often choking or struggling with dysphagia, as well as shortness of breath, particularly when talking or engaging in physical activities. 

Reasons for undergoing the procedure  

Some individuals with mild voice impairments caused by vocal cord paralysis may still meet their vocal demands without surgery. However, surgery might be recommended when symptoms become severe, life-disrupting, or potentially life-threatening. If you’re finding it difficult to meet the vocal demands of your work or daily life, medicalization laryngoplasty can be an effective solution to restore vocal function. 

Conditions and procedures that may lead to the need for thyroplasty: 

• Autoimmune diseases: Myasthenia gravis 
• Cancers: Lung cancer, thyroid cancer 
• Cancer treatments: Radiation therapy to the head, neck, or chest 
• Neurological conditions: Parkinson’s disease, stroke 
• Surgeries: Neck or chest surgery 
• Trauma: Injuries to the neck or chest 
• Tumors: Brain, neck, or chest tumors 
• Respiratory infections: Bronchitis, the common cold, flu 
• Breathing tubes: Intubation or mechanical ventilation 

Before the procedure  

You should adhere to the pre-procedure instructions provided by your doctor. For example, you will have to:  

• Fast (no food or liquids) for a predetermined amount of time prior to operation.  
• Give up smoking.  
• Quit taking vitamins, herbal supplements, and prescription drugs.

During the procedure  

A surgical operation called a thyroplasty is performed in an operating room.  

When treating unilateral vocal cord paralysis with a thyroplasty, your surgeon will:  

• Locates your voice box by making a little incision in your neck.  
• Makes a small opening next to your vocal chord in your voice box.  
• Evaluates your voice and inserts a personalized implant to enhance your vocal quality.  
• The incision is closed using absorbable stitches.  
• Fastens a bandage around your throat. [

Risks 

Bleeding and infection are risks associated with any surgery. The incision will leave a tiny scar on your neck. 

For a short while following surgery, as your voice box heals, some of the pre-surgical symptoms can resurface. You can experience short-term vocal changes, hoarseness, neck pain, and trouble swallowing and breathing. These adverse effects are rare and never lasting.  

Outcome 

You will either spend the night in the hospital or be released the same day. Although you should refrain from speaking for a few days, total quiet is not required.

When you start chatting again, don’t talk too much. That means no shouting, blaring, or drawn-out discussions. You are free to get back to your regular correspondence after a week.  

Other vocal cord paralysis symptoms can be treated and your voice can be restored with a thyroplasty. Vocal function frequently improves significantly for people. 

To facilitate healing:  

• If you have a sore throat, start with soft foods and drink lots of fluids.  
• For three days following surgery, avoid taking a shower and keep the area of your neck that is bandaged dry.  
• Adhere to your doctor’s prescription for painkillers, steroids, and antibiotics.  
• Steer clear of heavy lifting (anything above fifteen pounds) and intense exercise (such as running) for a period of two weeks. It’s okay to walk.  
• If your doctor recommends it, take part in voice treatment.

Rarely, your doctor might have to remove or modify your implant. However, the implant is frequently fixed.