Thyroplasty: a new approach.

A new type of thyroplasty implant (prosthesis) has been designed to be used of a surgical operation that accomplishes medial displacement of a paralyzed vocal cord. The implant is inserted through a rectangular window fashioned in the thyroid lamina on the side of the vocal cord paralysis. Instruments for measuring the location and outline of the window in the thyroid lamina are presented. A thyroplasty saw blade is introduced. By using this blade, a window of precise measurement can be constructed without injury to the underlying perichondrium. The implant is constructed from a biocompatible, medical-grade polymer. Four sizes each are available for the male and female larynges. The proper-size implant can be selected with a measuring device. It is not necessary to alter the implant at the time of surgery; it snaps into place and suturing is not necessary. Once the implant is inserted, its medial or lateral displacement is not possible; on the other hand, the implant can be easily removed if vocal cord function returns, or if a change to a different-size implant is indicated. The design of the implant will close the posterior commissure.