Medialization Laryngoplasty (Thyroplasty)

A medialization laryngoplasty, also known as Type I thyroplasty, is surgery to treat paralysis in one of your vocal cords. It’s also treatment for a weak vocal cord.

Your vocal cords are two bands inside your voice box. They open when you breathe and close or join when you speak. If one of the cords can’t move or is weak, your voice may be scratchy or breathy. Whispering may be the only way you can talk.

In medialization laryngoplasty (mee-dee-uh-lih-ZAY-shun luh-RING-goh-plas-tee), your surgeon places an implant into your voice box. The implant helps your vocal cords close and keeps the weak or paralyzed one in place.

How should I prepare for this procedure?

You should follow your healthcare provider’s instructions on steps to take before the procedure. For instance, you may need to:

• Fast (not eat or drink) for a certain period before surgery.
• Quit smoking.
• Stop taking medications, vitamins and herbal supplements.
• Plan a way to communicate for the first three days after surgery, since you’ll need to rest your voice for several days.

What happens during thyroplasty?

You’ll have local anesthesia. That means you’re awake during the procedure, but you don’t feel any pain. Your surgeon will:

1. Make a small cut (incision) in the front of your neck and locate your voice box.
2. Create a small window in your voice box alongside your vocal cord.
3. Place the implant next to the affected vocal cord.
4. Ask you to say a few words so your surgeon can check that the implant makes your voice stronger.
5. Close the incision with dissolvable stitches.
6. Place a bandage on the incision.

This procedure takes about 90 minutes to complete.

What are the potential benefits and risks of this procedure?

Medialization laryngoplasty can help restore your voice and treat other symptoms of vocal cord paralysis. People often experience a significant improvement in their vocal function. Potential risks include the following temporary side effects:

• Sore neck
• Hoarseness or other changes in your voice
• Difficulty breathing and swallowing

What happens after a medialization laryngoplasty?

You may go home after you recover from anesthesia. But your surgeon may decide you should stay overnight in the hospital so your care team can watch for any issues.

Your team will explain how you can take care of yourself as you recover. They’ll give you specific instructions. In general, you should:

• Rest your voice for the first three days. That means no talking, whispering or laughing. After that, keep giving your voice a break by avoiding long conversations.
• Take medication as prescribed, like pain relievers, antibiotics and steroids.
• You may be able to remove the bandage two days after surgery. But you need to keep your neck dry for three days. You can take a bath, but you shouldn’t take showers.
• Drink plenty of fluids. Stick with soft foods if your throat is sore.
• Avoid lifting anything that weighs more than 15 pounds for two weeks after surgery.
• Avoid strenuous activities like running or cycling for two weeks after surgery. Walking is OK.

Is this procedure permanent?

The device is often permanent. Very rarely, your surgeon may need to remove or reposition your implant.

When To Call the Doctor

You should call your healthcare provider if you experience:

• Difficulty breathing
• Extreme pain
• Signs of infection, like a white discharge from the incision or a fever greater than 101 degrees Fahrenheit (38.4 degrees Celsius)
• Swelling or bleeding at the incision

What are other types of thyroplasty?

Thyroplasty refers to surgery to treat voice disorders, vocal cord issues or to change the pitch of your voice. Medialization laryngoplasty to treat vocal cord paralysis is Type I thyroplasty. There are other types, but healthcare providers rarely perform them. Those types are:

• Type II: This is surgery that treats spasmodic dysphonia. Your surgeon sets your vocal cords apart and readjusts the supportive tissue in your voice box that keeps your vocal cords in place.
• Type III: This procedure involves shortening your vocal cords so your voice sounds deeper.
• Type IV: This procedure lengthens your vocal cords so your voice sounds higher.