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[External vocal fold medialization: surgical experiences and modifications]

G Friedrich1

  • 1Klinische Abteilung für Phoniatrie, Hals-, Nasen-, Ohren-Universitätsklinik Graz.

Laryngo- Rhino- Otologie
|April 2, 1998
PubMed
Summary

External vocal fold medialization is a safe and effective surgical technique for glottic insufficiency, offering significant improvement in vocal function. Further modifications may enhance outcomes for all patients.

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Area of Science:

  • Otolaryngology
  • Phonosurgery

Context:

  • Vocal fold medialization via external approach has evolved significantly since its initial report.
  • Isshiki's work in the 1970s revitalized and expanded these techniques, leading to current widespread use.

Purpose:

  • To review surgical experience with the original vocal fold medialization technique and its modifications.
  • To evaluate the safety, efficacy, and limitations of external vocal fold medialization.

Summary:

  • A retrospective study analyzed 53 patients undergoing external vocal fold medialization for glottic insufficiency, primarily due to unilateral laryngeal palsy.
  • The Isshiki technique was used in 32 patients, while 21 received modified procedures, including implants made of glass ionomer cement or titanium sheets.
  • The procedure demonstrated significant reduction in glottic insufficiency with no complications, though complete closure of large gaps was not always achieved.

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Impact:

  • External vocal fold medialization is a safe, reversible, and revisable procedure suitable for various glottic insufficiencies.
  • While effective, limitations exist, particularly with large glottic gaps, prompting ongoing development of new implants and surgical modifications.
  • Further advancements aim to establish external vocal fold medialization as a standard procedure with improved functional results and minimal patient risk.