Thyroplasty (Type I) was performed in 34 patients with unilateral vocal cord paralysis. Before and after operation, voice analysis and aerodynamic phonatory tests were performed. The thyroplasty was always done under local anesthesia with modified NLA, so that intra operative adjustments could produce optimal phonation and ensure satisfaction for both the patient and the operator. The patient was requested to phonate and sing to see the effect on the voice quality by medialization of the vocal cord through a window in the throid cartilage. A silicon plug, which had a ditch to fit the cut edge of the window, was inserted through the window, Our data indicate that thyroplasty is very effective in improving the voice in patients with a median or paramedian position of the paralyzed cord, but produces a limited improvement of phonatory function in patients with intermediate positions of the paralyzed vocal cord who have less than 3 seconds of maximum sustained phonation.
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