Thyroplasty

What is thyroplasty?

Thyroplasty is a surgical procedure performed for vocal cord paralysis. It is used to improve the patient’s voice and coughing ability. The procedure alters the thyroid cartilage of the larynx (the voice box) that houses the vocal cords, in order to change the length or position of the cords.

Thyroplasty is a surgical procedure performed for vocal cord paralysis.

What causes vocal cord paralysis?

The vocal cords are located at the entrance of the trachea. Normally, the vocal cords are in the open position when at rest to allow breathing. When speaking, the vocal cords close and vibrate. When the vocal cords are paralyzed there is a weakness in at least one of the cords causing hoarseness and even mild choking.

How is vocal cord paralysis treated?

Treatment depends on the cause. Speech therapy is the main treatment, but if this does not help, then vocal fold injections, such as fat or collagen, can add some volume to the vocal folds. If the vocal cord is completely paralyzed, then the surgical procedure of thyroplasty is performed.

How is thyroplasty performed?

The brief procedure is performed under local anesthesia and intravenous sedation, so that the surgeon can check the patient’s voice throughout the process. A small hole is made in the neck area of the larynx and the thyroid cartilage is removed to provide access to the vocal cords. An implant is placed near the vocal cords, which pushes the vocal cords closer to the midsection. Once in place, a fiberoptic scope is inserted, which allows the surgeon to view the larynx and check that the implant is in the correct position. The patient may then be asked to speak during the laryngoscopy to allow the surgeon to check the movement of the vocal cords.

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Risk factors for thyroplasty

The procedure is generally safe, but, as with all operations, complications can still arise. These include:

  • Poor voice quality (hoarseness), worsening of the voice is rare.
  • Difficulty breathing: swelling after surgery.
  • Migration of the implant: there have been reports of migration into the airway or neck.
  • Bleeding: this is rare, but typically stops on its own
  • Infection: treated with antibiotics or surgery in rare cases
  • Neck pain, which is common after surgery

For more information, consult an ENT expert.