[Medialization thyroplasty with the VOIS implant : Voice outcomes and experiences]

Unilateral vocal fold paralysis (UVFP) often leads to considerable limitations in voice quality and voice-related quality of life. Medialization thyroplasty (MT) is an established procedure for voice rehabilitation in cases of glottic insufficiency. Since December 2019, the APrevent® Vocal Implant System (VOIS, APrevent Biotech, Vienna, Austria) has been available in Germany as the first secondarily adjustable implant.

A retrospective evaluation included 12 patients who received MT with the VOIS implant. Voice quality was analyzed multidimensionally at timepoints T0 (preoperative), T1 (2-3 months postoperatively), and T2 (6 months postoperatively).

Significant improvements were observed in all examined parameters. The mean maximum phonation time (MPT) increased from 5.79 s (T0) to 10.07 s at T1 (p < 0.001) and to 13.22 s at T2 (p = 0.001). Maximum sound pressure level (SPLmax) increased from 77.08 to 86.09 dB at T1 (p = 0.004) and to 86.17 dB at T2 (p = 0.005). Perceptual voice quality, particularly breathiness, improved significantly from 2.29 to 0.73 at T1 (p = 0.004) and to 0.67 at T2 (p = 0.002). Additionally, there was a reduction in the VHI-12 score from 30.73 preoperatively to 11.29 at T1 (p = 0.016) and to 15.22 at T2 (p = 0.008). No significant changes were noted between T1 and T2.

Medialization thyroplasty with the VOIS implant resulted in significant improvements in voice quality and voice-related quality of life. The unique feature of the VOIS system, i.e., its secondary adjustability without a second surgery, offers potential for further optimization. Further studies are needed on the value of volume correction and the differential indications between MT and reinnervation techniques in UVFP.