Three Cases of Broken Titanium Bridge after Type 2 Thyroplasty

Abstract

Type 2 thyroplasty (TP2) using a titanium bridge (TB) is a standard surgery used to treat adductor spasmodic dysphonia (ADSD). We report 3 cases of broken TB after TP2. The patients complained of spasmodic or weak voice continuing after TP2, so a second TP2 was carried out. During the second TP2, in 2 cases the TB was seen to have previously been broken, and in 1 case the TB broke intraoperation. The broken TBs were checked by scanning electron microscope, and all sections showed characteristics typical of metal fatigue caused by repeated bending. If a TB is bent numerous times, it will break on the thyroid cartilage. However, so long as the central part of the TB remains unbroken, the voice does not become spasmodic. TBs should not be bent more than once, as repeated bending will cause the TB to break.