Type I thyroplasty for unilateral vocal fold palsy: Silastic or titanium implant?

Abstract

Introduction: Process of speech involves adduction of true vocal cords, and their palsy results in dysphonia with or without aspiration. Medialization thyroplasty is the standard of care and involves insertion of an implant to achieve apposition. We conducted a randomized prospective study to evaluate two types of implants (Silastic vs. titanium) in terms of surgical time and perceptive, acoustic, and aerodynamic evaluation. Materials and Methods: Twenty-six patients were randomized into two groups and were implanted one type of implant. They were evaluated and compared on the basis of voice handicap index (VHI), voice quality evaluation (VQE), and maximum phonation time (MPT). Results: The mean time taken for Silastic implantation was 83.07 min and for titanium implantation was 52.16 min. VHI and VQE decreased significantly following implantation in both groups, while MPT increased in both groups significantly. There was no significant difference between two groups. Conclusion: Medialization thyroplasty with both types of implants achieves good and comparable results. Silastic implant surgery takes longer time but is relatively inexpensive.