Thyroplasty Type 1

Abstract

Thyroplasty type 1 has been indicated for cases exhibiting a small glottal gap during phonation. This technique has been considered to have little effect on cases with a large glottal gap or when there is a difference in level between the two cords. To apply this operation to patients with a larger glottal chink, we modified the surgical technique to allow for insertion of a large silastlc prosthesis. Severing the perichondrium may cause intrusion of the prosthesis into the thyroarytenoid muscle, which in turn may impede vocal cord vibration. To insert the larger prosthesis without severing the inner perichondrium, the perichondrium surrounding the window was elevated broadly. The window was made about 3 mm posterior to the original method in order to improve the posterior glottal gap. Although this modified thyroplasty type 1 may be applied to most patients with a large glottal gap, the arytenoid adduction technique may be necessary in some extraordinary cases.