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Factors Associated With Type 1 Thyroplasty Revision: Insights From the TriNetX Database
Christian Leonardo1, Alexander Bjorling2, Keith A Chadwick2
1Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.
The Laryngoscope
|July 30, 2025
Summary
Revision rates for type 1 thyroplasty (T1T) were 8.02%, with older age and certain comorbidities like pulmonary or neurological conditions increasing the likelihood of needing revision surgery. These findings aid in patient selection and counseling for T1T.
Area of Science:
- Laryngology
- Surgical Outcomes
- Voice Restoration
Background:
- Type 1 thyroplasty (T1T), also known as medialization laryngoplasty (ML), is a surgical procedure to address glottic insufficiency.
- Existing literature indicates a wide range of revision rates for T1T, from 5% to 40%, highlighting a need for further investigation into influencing factors.
Purpose of the Study:
- To determine the revision rate of T1T.
- To identify specific patient demographic, surgical history, and comorbidity factors associated with the need for revision T1T.
Main Methods:
- A retrospective cohort study design was employed.
- Data from 4029 patients who underwent T1T (CPT 31591) were analyzed using the TriNetX global health data network.
- Revision was defined as a second T1T procedure performed at least 30 days post-initial surgery; patient factors were compared between revision and non-revision groups.
Main Results:
- The overall revision rate for T1T was 8.02% (323 out of 4029 patients).
- Patients requiring revision were slightly older (63.5 vs. 61.2 years) and more likely to be of White or American Native race.
- Comorbidities significantly associated with revision included pulmonary diseases, neurological conditions, and mental health disorders, as well as a prior history of thyroidectomy or tracheostomy.
Conclusions:
- This study represents the first comprehensive analysis of revision T1T factors utilizing the TriNetX database.
- Specific demographic characteristics and patient comorbidities appear to influence the probability of requiring revision T1T.
- These insights can inform patient selection processes and enhance preoperative counseling for individualized patient care.
