Medialization laryngoplasty with expanded polytetrafluoroethylene. Surgical technique and preliminary results

Symptomatic unilateral laryngeal paralysis may be treated successfully by a wide variety of surgical techniques. These techniques share the concept that stabilization of the paralyzed vocal fold in a median position will improve glottic function. Medialization laryngoplasty with expanded polytetrafluoroethylene (ePTFE) incorporates the general principles of established medialization procedures, yet is unique in its simplicity. The technique does not require special instrumentation, employs incremental adjustment of vocal fold position, and utilizes an implantable material with a long history of patient safety. We describe this new technique and report on the outcome of our first 16 patients treated. No surgical or implant-related complications have occurred. Voice results were measured from preoperative and postoperative video and voice recordings by four independent observers using a standardized assessment tool. Voice grade and breathiness were evaluated on a four-point scale (0 = normal and 3 = abnormal, extreme). The mean overall grade improved from 2.3 +/- 0.6 to 1.1 +/- 0.6, and breathiness from 2.0 +/- 0.8 to 0.4 +/- 0.4. The technique is simple, the implant material has been in clinical use for decades, and the voice results are good to excellent.