Complications after type one thyroplasty: is day-case surgery feasible?

Area of Science:

• Otolaryngology
• Laryngeal Surgery
• Voice Restoration

Background:

• Isshiki type one medialisation thyroplasty is a standard surgical procedure for unilateral vocal fold immobility.
• It can also be adapted for bilateral vocal fold bowing, such as in presbyphonia.
• Evaluating post-operative complications and suitability for day-case surgery is crucial for optimizing patient care.

Purpose of the Study:

• To assess the incidence and timing of post-operative complications following type one thyroplasty.
• To determine the feasibility of performing type one thyroplasty as a day-case procedure.
• To identify patient factors associated with increased complication risk.

Main Methods:

• Retrospective analysis of 57 consecutive patients undergoing type one thyroplasty (unilateral or bilateral) between 2003 and 2006.
• Outcomes were assessed based on subjective, perceptual, and quantitative voice improvement.
• Complications were systematically documented.

Main Results:

• All 57 patients were discharged within 24 hours of afternoon surgery, indicating day-case suitability.
• Complications occurred in 7% of patients: one post-operative hematoma (warfarin user), two wound infections (revision surgery), and one implant erosion (previous radiotherapy).
• No airway compromise complications were observed.

Conclusions:

• Complications were primarily associated with anticoagulation, revision surgery, or compromised laryngeal tissue.
• Careful patient selection, excluding those with risk factors, can minimize complication rates.
• Type one thyroplasty is a suitable day-case procedure for unilateral or bilateral vocal fold paralysis when appropriate patients are selected.