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Thyroplasty type I with ceramic shim

N Sakai1, N Nishizawa, J Matsushima

  • 1Department of Otorhinolaryngology, Hokkaido University, School of Medicine, Sapporo, Japan.

Artificial Organs
|August 1, 1996
PubMed
Summary
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Ceramic shims offer a safe alternative to silicone for Isshiki thyroplasty type I, improving voice and glottic function in patients with recurrent laryngeal nerve paralysis.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Biomaterials Science

Background:

  • Silicone shims in Isshiki thyroplasty type I can cause side effects.
  • Unilateral recurrent laryngeal nerve paralysis leads to glottic insufficiency and voice impairment.

Purpose of the Study:

  • To evaluate the efficacy and safety of using ceramic shims as an alternative to silicone in Isshiki thyroplasty type I.
  • To assess voice and glottic function improvements following ceramic shim implantation.

Main Methods:

  • Ten patients with unilateral recurrent laryngeal nerve paralysis underwent Isshiki thyroplasty type I using custom-sized ceramic shims.
  • Ceramic shims were inserted into a fenestration in the thyroid ala, tailored to the degree of glottic insufficiency.
  • Postoperative voice analysis included subjective assessment, laryngoscopy, maximum phonation time, and mean flow rate.

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Main Results:

  • All 10 patients reported subjective voice improvement.
  • Laryngoscopy revealed improved glottic closure in most patients.
  • Significant improvements were observed in maximum phonation time (average 3.7s increase) and mean flow rate (average 331 ml/s decrease).

Conclusions:

  • Ceramic shims are a viable and effective alternative to silicone for Isshiki thyroplasty type I.
  • This novel application of ceramic material in thyroplasty demonstrates positive outcomes for voice and glottic function.
  • Further research is warranted to explore the long-term efficacy and compare ceramic with other thyroplasty materials.