Teflon versus thyroplasty versus nerve transfer: a comparison.

Surgical rehabilitation of the paralyzed larynx is currently performed by Teflon injection, thyroplasty, and reinnervation techniques. Proponents of the two newer techniques maintain that they are preferred to Teflon injection because superior phonatory quality is achievable. This paper was written in an attempt to dissect the issues regarding this question. Teflon remains the quickest and least expensive procedure, but further experience with stroboscopic and other voice analyses reveals that the other procedures demonstrate some superiority in phonatory quality over Teflon. In this author's hands, the nerve transfer offers the best opportunity to achieve a normal phonatory voice. In addition, it is the only one of the three procedures that leaves the vocal cord entirely undisturbed--important in the event one of the other two procedures becomes necessary.