Laryngeal Framework Surgeries for Patients with Unilateral Vocal Fold Paralysis

Abstract

Thyroplasty type I (TPI) and arytenoid adduction (AA) in laryngeal framework surgery, as developed by Isshiki, have been the surgeries of choice for unilateral vocal fold paralysis (UVFP). This paper mainly describes the surgical indications and techniques of these surgeries performed in our department. When performing TPI, it is important to correctly open the window in the thyroid cartilage and preserve its inner perichondrium. It is also necessary to devise a way to deal with osteochondral lesions found in the thyroid cartilage. However, a more reliable and less invasive way of approaching the muscle process of the arytenoid cartilage when performing AA is sought. Using preoperative three-dimensional reconstructed computed tomography (3DCT) images, we can determine the fenestration position during TPI. Furthermore, by evaluating the locations of inserted material after TPI or arytenoid cartilage after AA using postoperative 3DCT images, we can obtain feedback on who to further improve our surgical technique.