A Novel Technique for Thyroplasty Type 1, With Prolene Mesh Implant

Abstract

Objective: To analyze the efficacy of a modified approach to thyroplasty type one using prolene mesh implant.

Study design: Interventional study.

Place and duration of study: Combined Military Hospital Kharian, Pakistan, in Ent department, from July 2020 to Jan 2021.

Methodology: Medialization thyroplasty with prolene mesh was performed on the patients satisfying the inclusion criteria. They were analyzed objectively as well as subjectively in terms of Mean Maximum phonation time, maximum word count, and visual analog score about the quality of voice. Data analysis was done with SPSS version 20. Pre-operative and post-operative records were compared using paired sample t-test.

Results: A total of 39 patients underwent vocal cord medialization with prolene mesh implant. The Mean age for medialization was 41.09 + 13.37. 23 patients were females and 15 were males. 26 patients had unilateral and 13 patients had bilateral vocal dysfunction. 18 of them had vocal dysfunction due to thyroidectomy, eight had idiopathic causes and 13 had miscellaneous. The improvement in mean visual analog score was 2.87 postoperatively. Median maximum phonation time increased about five seconds postoperatively, seven seconds in males, and 4.5 seconds for females. The maximum word count increased from 11.33 preoperatively to 18.28 postoperatively. There were no major complications observed in our study.

Conclusion: These results were comparable to many other studies for vocal cord medialization with different implant materials. But prolene mesh implant offers an easily available yet cost-effective alternative with similar benefits.

Level of evidence: III (Treatment benefits: Non-randomized controlled cohort/follow-up study).

Keywords: Voice therapy—Vocal fold paralysis/paresis/motion impairment— Phonosurgery Airway— Voice modeling.