- Country: TAIWAN
- Official Title: 喉科主任/副系主任
- Department: 馬偕紀念醫院耳鼻喉頭頸部 馬偕醫學院聽力暨語言治療學系
Speech Title
Tips and Pitfalls of VOIS Implant Thyroplasty
使用VOIS植入物進行甲狀軟骨整形術第一型的需知
Unilateral vocal fold paralysis (UVFP) is a common disorder caused by recurrent laryngeal nerve (RLN) injury, which may be either iatrogenic, idiopathic, or due to other intrinsic/extrinsic causes, resulting in different degrees of incomplete glottal closure with symptoms including voice-, breathing- and swallowing- impairment.
Thyroplasty type I has been widely accepted as the standard phono-surgical procedure in UVFP patients, because of its long-lasting effect and demonstrable improvement in vocal performance. Despite its widespread use, the revision rate ranges from 8 to 33%, reasons include improper implant size, persistent posterior glottal gap, and implant migration. The three key features of an ideal implant to be inserted into the larynx are “compatibility”, “adjustability” and “reversibility”. Aprevent® Vocal Implant System Implant (VOIS) is a novel implant which is inert, intraoperatively and postoperatively adjustable and the procedure is reversible. Therefore, it can reduce revision rates and complications. Furthermore it is implanted through a standardized procedure making it easier to reproduce the results.
Here, we want to share our experiences in thyroplasty with VOIS. The followings are some tips and pitfalls to facilitate a successful implantation of VOIS.
# Determine the proper size of implant based on the thyroid cartilage lamina length.
# Create a 6×11 mm rectangular window parallel to the inferior border of the lamina
# Keep the window as low as possible.
# Keep the start of the window far away enough from the anterior height of lamina.
Do not medialize too anteriorly.
# Be careful and avoid fracture of the anterior lower rim of the window.
# Avoid too much manipulation of the inner perichondrium and tissues inside the window.