Thyroplasty Techniques

Thyroplasty is a reliable and beneficial surgical procedure for patients with impaired voice or aspiration and offers a remedy for those who suffer deleterious psychological consequences from these conditions. Some of these conditions may be a result of factors like tension of the vocal fold brought about by overstraining the vocal cords, paralysis of the vocal cord, smoking, cancer and other factors. Known as laryngoplastic phonosurgery or laryngeal framework surgery, thyroplasty essentially corrects the position of the vocal fold in the throat. It helps restore broken or changed voice.

Thyroplasty Surgery

• Thyroplasty is a microscopic surgery that is done under general anesthesia. At its simplest, the procedure consists of injecting the vocal folds (flaps) with normal saline. The flap is then microscopically dissected using cold steel surgical instruments. Lasers are also used in cases in which it is not possible for traditional surgical instruments to reach. Once this is done, the affected mass is either removed or is augmented with fascia or fat, as the case demands.

  There are four major techniques or types of thyroplasty: Type I, II, III and IV.

Type I and II

• Also known as medialisation laryngoplasty, Type I thyroplasty is recommended for patients who have had a paralysis of the throat and have a suffered voice tone changes because of the paralysis. This procedure, which has replaced the previously popular method known as Teflon injection technology, addresses the underlying cause of voice change. An opening is made in the thyroid sheet of the neck while you are under local anesthesia. The paralyzed part is located in this opening. A thyroid cartilage is inserted, so the normal cord touches the affected part, thus closing the gap between the two, which is what caused the change in voice.

  Type II is advised for patients with a condition called spastic dysphonia. Under this condition, patients experience involuntary movement of muscles (or one of the muscles) in the throat when they speak. This technique takes these muscles away from the midline, eliminating the movement. This is carried out under local anesthesia

Type III and IV

• Type III thyroplasty is usually performed on adolescents. When some people reach puberty, they don't get the desired change in voice. In females with high or masculine voice or vice versa, this procedure can correct this. The vocal cords are pushed back to their posterior position, shortening the vocal cord and reducing the pitch of the voice.

  Type IV thyroplasty is essentially done to lower the pitch of feminine voice. This procedure increases the length of the vocal cord, as a sort of a reverse of Type III. In this method, sutures are put into the area between the cricoid cartilage and the thyroid.