Abstract
Objective: To describe a new method of medialization thyroplasty using a modified preformed nasal silicone implant.
 Methods: 
 Design: Surgical Innovation
 Setting: Tertiary Private Hospital
 Participants: Four patients underwent medialization thyroplasty using a pocket and nasal implant technique performed by the senior co-author. The indication for medialization thyroplasty for these patients was hoarseness secondary to unilateral vocal fold paralysis of more than 6 months duration, and documented by flexible fiberoptic laryngoscopy. The outcomes were described with comparison of pre- and post-operative subjective voice assessment.
 Results: Operative time was 15–30 minutes. Post-operative subjective improvement of voice quality was evident. Scars were minimal and aesthetically acceptable. The procedure could be done on an outpatient basis. 
 Conclusion: Medialization thyroplasty via a pocket and silicone implant technique is initially effective and may be a worthwhile alternative to the usual window technique.
 Keywords: unilateral vocal cord paralysis; medialization thyroplasty; Isshiki thyroplasty; silicone implant
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