The Use of a Titanium Plate for Medialization of the Vocal Fold

The Type 1 Thyroplasty or Medialization Thyroplasty was first reported in the 1970s by Isshiki et al for treating voice disorders resulting from vocal fold paralysis or atrophy. Since then, this therapeutic modality has gained world-wide popularity, and a number of modified methods were also reported with generally satisfactory results.Silicone block fabricated in situ had long been utilized to fix the window cartilage without any significant complication, however, containment failures from silicone bag breast implants and their resultant negative side-effect led to difficulties in obtaining silicone for any surgical treatment whatsoever. Gradually, Gore-tex, as used for correcting vascular problems, had replaced silicone, because of its ease in handling and of its excellent biocompatibility. However, it did not guarantee precision in the adjustment of medialization, especially when the window-cartilage was removed and/or when the Gore-tex sheet was packed in a wrong direction. In this respect, Titanium, well known for its excellent biocompatibility, seems better suited for precision and long-lasting effectiveness. Friedrich had already reported excellent results. Based on our abundant experience with Titanium Bridges in type 2 thyroplasty for spasmodic dysphonia, we utilized a simple thin and bendable Titanium plate so as to realize adequate medialization on site.