This presentation discusses medialization thyroplasty using gortex

1. Medialization Thyroplaty using Gor-Tex

3. Causes speech problems (Wasting of voice)

4. Aspiration – If the opposite cord compensates inadequately

6. Cord injection – Teflon, fat, collagen

7. Medialization thyroplasty using Teflon / Gor-Tex

8. Re-innervation techniques (early stages)

9. Gor-Tex was first used as an implant material for medialization by Hoffman and McCullouch in May 1996

11. Unilateral vocal fold scarring / soft tissue loss

12. In select cases of Parkinsonism with vocal fold atrophy

13. In patients who aspirate due to vocal fold paralysis without the opposite cord compensating adequately

15. Malignant lesions involving larynx

16. Poor abduction of contralateral vocal fold as this could compromise the airway

17. Patients with poor pulmonary reserve

19. It is malleable

20. Its position can easily be adjusted via the thyroid cartilage window

21. Can easily be inserted via a small opening

22. Reversible

24. Creates less oedema than silastic hence over correction is not a possibility

25. Quality of voice is pretty good

27. Horizontal skin crease incision starting at the midportion of thyroid cartilage extending to the paralysed side

28. Strap muscles are separated and held apart by an umbilical tape

30. Thyroid perichondrium is incised in the midline and extended laterally

31. Cricoid laminae is skeletonized up to the level of cricothyroid membrane on the paralyzed side

33. Lower border of window should be atleast 3 mm above cricothryoid membrane

34. Anterior border should be about 8 mm posterior to midline

35. Fissure burr could be used to create the window

36. Cartilage cuts

38. The inner perichondrium is incised posteriorly and inferiorly

39. A septal elevator can be introduced via the inferior margin of thyroid lamina and medial pressure can be applied to assess the patient's voice

40. If result is good then Gor-Tex can be inserted

42. Insertion is performed via the inferior margin of thyroid lamina and delivered via the cartilage window

43. Amount of Gor-Tex insertion depends on the quality of voice

44. Gor-Tex inserted

47. Thankyou