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Medialisation thyroplasty with tensor fascia lata: a novel approach for reducing post-thyroplasty complications

Published online by Cambridge University Press:  21 February 2018

T N Chao ,
A Mahmoud ,
K Rajasekaran  and
N Mirza
T N Chao*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, USA
A Mahmoud
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, USA
K Rajasekaran
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, USA
N Mirza
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, USA
*
Address for correspondence: Natasha Mirza, 3400 Spruce Street, 5 Silverstein, Philadelphia, Pennsylvania 19104, USA Fax: +1 215 662 4182 E-mail: natasha.mirza@uphs.upenn.edu
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Abstract

Background:

Medialisation thyroplasty is considered the ‘gold standard’ treatment for unilateral vocal fold paralysis, enabling improvement of voice and swallowing function, and preventing life-threatening aspiration events. The most commonly used laryngeal implants induce some degree of local tissue inflammatory response, and carry the risk of immediate or delayed implant extrusion.

Methods:

This paper describes a novel approach for medialisation thyroplasty. Specifically, it utilises a ribbon of autologous tensor fascia lata harvested at the time of surgery. This is layered within the paraglottic space in a manner similar to Gore-Tex thyroplasty.

Results:

Thus far, this method has been accomplished in two patients with unilateral vocal fold paralysis, who also received prior radiotherapy to the head and neck.

Conclusion:

Given the increased risk of post-operative wound breakdown and infection in irradiated patients, it is suggested that this new approach will lead to improved outcomes, and a decrease in complications such as extrusion or wound infection, particularly in this patient population.

Keywords

LaryngoplastyMedialization ThyroplastyUnilateral Vocal Cord ParalysisAutologous TransplantationFascia LataRadiation InjuriesSurgery

Information

Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 4 , April 2018 , pp. 364 - 367
Copyright
Copyright © JLO (1984) Limited 2018 

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Footnotes

Presented as a poster at the Combined Otolaryngology Spring Meetings, American Broncho-Esophagological Association, 27 April 2017, San Diego, California, USA.

References

1Siu, J, Tam, S, Fung, K. A comparison of outcomes in interventions for unilateral vocal fold paralysis: a systematic review. Laryngoscope 2016;126:1616–24.Google Scholar
2Harries, ML. Unilateral vocal fold paralysis: a review of the current methods of surgical rehabilitation. J Laryngol Otol 1996;110:111–16.CrossRefGoogle ScholarPubMed
3Benninger, MS, Crumley, RL, Ford, CN, Gould, WJ, Hanson, DG, Ossoff, RH et al. Evaluation and treatment of the unilateral paralyzed vocal fold. Otolaryngol Head Neck Surg 1994;111:497–508.CrossRefGoogle ScholarPubMed
4Young, VN, Zullo, TG, Rosen, CA. Analysis of laryngeal framework surgery: 10-year follow-up to a national survey. Laryngoscope 2010;120:1602–8.CrossRefGoogle ScholarPubMed
5Alonso, A, Kaimal, S, Look, J, Swift, J, Fricton, J, Myers, S et al. A quantitative evaluation of inflammatory cells in human temporomandibular joint tissues from patients with and without implants. J Oral Maxillofac Surg 2009;67:788–96.CrossRefGoogle ScholarPubMed
6Sclafani, AP, Romo, T. Biology and chemistry of facial implants. Facial Plast Surg 2000;16:3–6.Google Scholar
7Rosow, DE, Al-Bar, MH. Type I thyroplasty in previously irradiated patients: assessing safety and efficacy. Otolaryngol Head Neck Surg 2015;153:582–5.CrossRefGoogle ScholarPubMed
8Shoffel-Havakuk, H, Merati, AL, Johns, MM 3rd. Is laryngeal framework surgery safe in the radiated larynx? Laryngoscope 2017;127:778–80.Google Scholar
9Langille, M, Singh, P. Static facial slings: approaches to rehabilitation of the paralyzed face. Facial Plast Surg Clin North Am 2016;24:29–35.Google Scholar
10Pinna Bde, R, Stavale, JN, Pontes, PA, Camponês do Brasil Ode, O. Histological analysis of autologous fascia graft implantation into the rabbit voice muscle. Braz J Otorhinolaryngol 2011;77:185–90.Google Scholar
11Reijonen, P, Leivo, I, Nevalainen, T, Rihkanen, H. Histology of injected autologous fascia in the paralyzed canine vocal fold. Laryngoscope 2001;111:1068–74.Google Scholar
12Girod, DA, McCulloch, TM, Tsue, TT, Weymuller, EA. Risk factors for complications in clean-contaminated head and neck surgical procedures. Head Neck 1995;17:7–13.Google Scholar
13White, JR, Orbelo, DM, Noel, DB, Pittelko, RL, Maragos, NE, Ekbom, DC. Thyroplasty in the previously irradiated neck: a case series and short-term outcomes. Laryngoscope 2016;126:1849–53.Google Scholar
14Netterville, JL, Stone, RE, Luken, ES, Civantos, FJ, Ossoff, RH. Silastic medialization and arytenoid adduction: the Vanderbilt experience. A review of 116 phonosurgical procedures. Ann Otol Rhinol Laryngol 1993;102:413–24.CrossRefGoogle ScholarPubMed
15Lam, PK, Ho, WK, Ng, ML, Wei, WI. Medialization thyroplasty for cancer-related unilateral vocal fold paralysis. Otolaryngol Head Neck Surg 2007;136:440–4.Google Scholar