Transoral silastic medialization for unilateral vocal fold paralysis

Head Neck. 2019 Sep;41(9):2947-2951. doi: 10.1002/hed.25774. Epub 2019 Apr 26.


Background: Medialization laryngoplasty has historically been performed through an external approach. The aim of our work is to demonstrate the feasibility of silastic vocal fold medialization transorally.

Methods: Patients with unilateral vocal fold paralysis requiring medialization laryngoplasty were included in this report. Silastic medialization was done through a transoral approach. A supraglottic laryngotomy is performed followed by dissection and tunneling in the paraglottic space. Silastic implant is inserted into the tunnel to medialize the vocal fold and the ipsilateral arytenoid. The laryngotomy is tightly closed by endoscopic sutures.

Results: A consecutive series of 22 patients are reported. All patients had dysphonia with significant glottic insufficiency. After endoscopic silastic medialization, voice and swallowing were significantly improved (P < .001). No postoperative complications or implant extrusion occurred in our series.

Conclusion: Silastic vocal fold medialization can be safely and effectively performed through a transoral approach with good results on voice and swallowing.

Keywords: R-TLM; medialization laryngoplasty; reconstructive transoral laser microsurgery; silastic implantation; unilateral vocal fold paralysis.

MeSH terms

  • Arytenoid Cartilage / surgery
  • Dysphonia / surgery
  • Feasibility Studies
  • Humans
  • Laryngoplasty / methods*
  • Lasers, Gas
  • Natural Orifice Endoscopic Surgery*
  • Prostheses and Implants*
  • Respiratory Aspiration / surgery
  • Vocal Cord Paralysis / surgery*