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Modified thyroplasty for unilateral vocal fold paralysis using an adjustable titanium implant

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Abstract

This study aimed to describe a new titanium thyroplasty implant that can be adjusted with a screw. Six Beagle dogs were randomly divided into experimental and control groups (n = 3). The titanium screw was implanted in the experimental group after the left recurrent laryngeal nerve was cut off under general anaesthesia. This procedure caused arytenoid cartilage internal shift, allowing the vocal cord to locate at the median and the glottis to close during phonation. No other operation was conducted in the control group. Each group, respectively, underwent video laryngoscopy, CT scan and histopathology before and after operation. After 4 months of follow-up, the video laryngoscopy results showed that the left arytenoid cartilage in the experimental group underwent internal adduct and shift, whereas the left vocal cords in the control group located at the paramedian position and exhibited fissure during phonation. CT scan results showed that the adjustable titanium screw was in proper position. Postoperative pathological examination showed that, in addition to early local inflammation, the laryngeal muscle may atrophy. The adjustable titanium screw requires a simple operation and can be significantly adjusted. The effect of the operation can be immediately observed without rejection. Therefore, this method is an efficient treatment for unilateral vocal cord paralysis.

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References

  1. Fang TJ, Li HY, Gliklich RE, Chen YH, Wang PC, Chuang HF (2008) Quality of life measures and predictors for adults with unilateral vocal cord paralysis. Laryngoscope 118:1837–1841

    Article  PubMed  Google Scholar 

  2. Isshiki N, Morita H, Okamura H, Hiramoto M (1974) Thyroplasty as a new phonosurgical technique. Acta Otolaryngol 78:451–457

    Article  CAS  PubMed  Google Scholar 

  3. Setlur J, Hartnick CJ (2012) Management of unilateral true vocal cord paralysis in children. Curr Opin Otolaryngol Head Neck Surg 20:497–501

    Article  PubMed  Google Scholar 

  4. Mesallam TA, Khalil YA, Malki KH, Farahat M (2011) Medialization thyroplasty using autologous nasal septal cartilage for treating unilateral vocal fold paralysis. Clin Exp Otorhinolaryngol 4:142–148

    Article  PubMed Central  PubMed  Google Scholar 

  5. Storck C, Fischer C, Cecon M, Schmid S, Gambazzi F, Wolfensberger M, Brockmann M (2010) Hydroxyapatite versus titanium implant: comparison of the functional outcome after vocal fold medialization in unilateral recurrent nerve paralysis. Head Neck 32:1605–1612

    Article  PubMed  Google Scholar 

  6. Chowdhury FR, Baker AL, Sataloff RT (2013) Bilateral Gore-Tex implant extrusion following type I thyroplasty. Ear Nose Throat J 92:E26–E27

    PubMed  Google Scholar 

  7. Hoffman MR, Witt RE, McCulloch TM, Jiang JJ (2011) Preliminary investigation of adjustable balloon implant for type I thyroplasty. Laryngoscope 121:793–800

    Article  PubMed Central  PubMed  Google Scholar 

  8. Christopoulos A, Saliba I, Péloquin L, Ahmarani C (2008) Adjustable laryngeal implant for unilateral vocal cord paralysis. J Otolaryngol Head Neck Surg 37:355–361

    PubMed  Google Scholar 

  9. Devos M, Schultz P, Guilleré F, Debry C (2010) Thyroplasty for unilateral vocal fold paralysis using an adjustable implant in porous titanium. Eur Ann Otorhinolaryngol Head Neck Dis 127:204–212

    Article  CAS  PubMed  Google Scholar 

  10. Schneider-Stickler B, Gaechter J, Bigenzahn W (2013) Long-term results after external vocal fold medialization thyroplasty with titanium vocal fold medialization implant (TVFMI). Eur Arch Otorhinolaryngol 270:1689–1694

    Article  PubMed  Google Scholar 

  11. Spear SA, Theler J, Sorensen DM (2008) Complications after the surgical treatment of malignant thyroid disease. Mil Med 173:399–402

    Article  PubMed  Google Scholar 

  12. Kang BC, Roh JL, Lee JH, Jung JH, Choi SH, Nam SY, Kim SY (2013) Usefulness of computed tomography in the etiologic evaluation of adult unilateral vocal fold paralysis. World J Surg 37:1236–1240

    Article  PubMed  Google Scholar 

  13. Umeno H, Chitose S, Sato K, Ueda Y, Nakashima T (2012) Long-term postoperative vocal function after thyroplasty type I and fat injection laryngoplasty. Ann Otol Rhinol Laryngol 121:185–191

    Article  PubMed  Google Scholar 

  14. Misono S, Merati AL (2012) Evidence-based practice: evaluation and management of unilateral vocal fold paralysis. Otolaryngol Clin North Am 45:1083–1108

    Article  PubMed  Google Scholar 

  15. Ayala MA, Patterson MB, Bach KK (2007) Late displacement of a Montgomery thyroplasty implant following endotracheal intubation. Ann Otol Rhinol Laryngol 116:262–264

    Article  PubMed  Google Scholar 

  16. Zeitels SM, Mauri M, Dailey SH (2004) Adduction arytenopexy for vocal fold paralysis: indications and technique. J Laryngol Otol 118:508–516

    Article  PubMed  Google Scholar 

  17. Iwamura S, Kurita N (1996) A newer arytenoid adduction technique for one-vocal-fold paralysis. Head Neck Surg 6:1–10

    Google Scholar 

  18. Su CY, Lui CC, Lin HC, Chiu JF, Cheng CA (2002) A new paramedian approach to arytenoid adduction and strap muscle transposition for vocal fold medialization. Laryngoscope 112:342–350

    Article  PubMed  Google Scholar 

  19. Su CY, Tsai SS, Chuang HC, Chiu JF (2005) Functional significance of arytenoid adduction with the suture attaching to cricoid cartilage versus to thyroid cartilage for unilateral paralytic dysphonia. Laryngoscope 115:1752–1759

    Article  PubMed  Google Scholar 

  20. Friedrich G (1999) Titanium vocal fold medializing implant: introducing a novel implant system for external vocal fold medialization. Ann Otol Rhinol Laryngol 108:79–86

    Article  CAS  PubMed  Google Scholar 

  21. Laccourreye O, El Sharkawy L, Holsinger FC, Hans S, Ménard M, Brasnu D (2005) Thyroplasty type I with Montgomery implant among native French language speakers with unilateral laryngeal nerve paralysis. Laryngoscope 115:1411–1417

    Article  PubMed  Google Scholar 

  22. Godlewski B, Radek M, Radek A (2009) Unorthodox technique of simultaneous reposition of an odontoid process fracture from a posterior pharyngeal wall approach and direct screw fixation from a submandibular approach. Ortop Traumatol Rehabil 11:61–67

    PubMed  Google Scholar 

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Acknowledgments

The current work was supported by funding from The Fund of the Advanced Medical Department of the Pudong New Area, Shanghai (No. PWZxkq 2014–04) and the Outstanding Leaders Training Program of Pudong Health Bureau of shanghai (Grant No. PWRL2012-04).

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Correspondence to Guangbin Sun.

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Wen, W., Sun, G., Sun, B. et al. Modified thyroplasty for unilateral vocal fold paralysis using an adjustable titanium implant. Eur Arch Otorhinolaryngol 272, 517–522 (2015). https://doi.org/10.1007/s00405-014-3037-z

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  • DOI: https://doi.org/10.1007/s00405-014-3037-z

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