Thyroplasty type I has been employed in treatment of patients with small glottal chinks during phonation due to unilateral vocal fold paralysis. To apply this operation to patients with larger glottal chinks, we devised a method of inserting a large silastic prosthesis between the inner perichondrium and the thyroid cartilage. Without severing the inner perichondrium, a large prosthesis is usually difficult to insert because of the stiffness of the perichondrium. Moreover, severing the perichondrium may cause an intrusion of the prosthesis into the thyroarytenoid muscle, that may then impede vocal fold vibration. In this report, we describe a new technique for elevating the inner perichondrium further to the posterior and inferior edges of the thyroid cartilage.
