Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)
- Volume 18 Issue 1
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- Pages.7-10
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- 2007
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- 2508-268X(pISSN)
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- 2508-5603(eISSN)
Medialization Thyroplasty with Silastic- Decision Making & Practical Points
Silastic을 이용한 내전 갑상성형술-적용 및 술기
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Choi, Hong-Shik
(Department of Otorhinolaryngology, The Institute of Logopedics & Phoniatrics, Yonsei University College of Medicine)
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최홍식
(연세대학교 의과대학 이비인후과학교실, 음성언어의학연구소)
- Published : 2007.06.15
Abstract
Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. The treatment of unilateral vocal cord paralysis has a long history, marked by technical innovations and improvements. These methods typically use endoscopic injection or implants to augment the volume of the affected vocal fold. The first known treatment, reported by Brunnings in 1911, was paraffin injection. The first thyroplasty medializing the paralysed vocal cord was performed by Payr in 1915 ; here, a cartilage door-flap was created from the thyroid ala to obtain better voice quality. In the 1970s, Isshiki systematized and developed the use of the external medialization by Payr. Later he modified his original technique, and achieved safer and better results. Many other methods were introduced for external medialization during the 1980s and 1990s. There has been couple of materials using for medialization laryngoplasty: silicone bloc, cartilage, goretex (polytetrafluoroethylene), titanium, etc. Among them, silicone bloc is the most popularly used material. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralysed vocal fold. In this paper, personal experience for using silicone bloc type I thyroplasty : decision making and practical points, long-term results and complication of the procedure will be discussed.