Unilateral recurrent paresis
Medialization thyroplasty (thyroplasty)
In thyroplasty, a cartilage/silicone wedge is inserted at the larynx through a skin incision (phonochirugy). Type I thyroplasty (according to Isshiki) results in static, permanent medialization of the vocal fold by paraglottic (“located next to the glottis”) insertion of an implant.
Indications (areas of application):
- Paralysis of the larynx (or inferior lyrngeal nerve “reccurens”; so-called vocal cord nerves), whether the cause was infection, surgery or injury,
- Defect of the larynx (e.g., due to previous tumor surgery).
Note: The surgical indication is usually made only 6 to 12 months after the onset of paresis, because thyroplasty is much more costly than augmentation, and therefore one wants to wait for a possible return of nerve function.
There is no risk of unfavorable scarring that could worsen the voice, since one operates at a safe distance from the vibrating soft tissues in the larynx that produce the voice.
The procedure is performed under local anesthesia (local anesthesia), so voice quality can be checked during surgery.
Vocal fold relining (augmentation)
Vocal fold relining is an augmentation (filling, relining, injecting) of the vocal folds with tissue fillers (= implant), which serves the plastic reconstruction of the vocal folds. The implants consist, for example, of hyaluronic acid, calcium hydroxyapatite, collagen and other biocompatible substances.
The advantage of augmentation is the low-invasive medialization of the membranous part of a vocal fold, as well as the possibility of choosing a temporary filler.
Indications
- Immediate help when conservative measures do not lead to sufficient voice improvement.
- For permanent vocal fold medialization
The procedure is performed under local anesthesia.
Augmentation is possible in almost all cases on an outpatient basis.
Bilateral recurrent paresis
Tracheostomy
In bilateral recurrent paresis, tracheostomy (tracheotomy) is often passagerly necessary because of marked dyspnea (shortness of breath).
