GLENN WALDMAN, MD; UTTAM K. SINHA, MD;
DANIEL KEMPLER, PHD; DALE H. RICE, MD

Los Angeles, CALIFORNIA

In the past, several techniques have been used to medialize the true vocal cord in unilateral vocal cord paralysis. Currently, the most popular approach to permanent vocal cord medialization is the placement of a Silastic implant through a window in the thyroid cartilage. We introduce a new technique by using a Gore-Tex implant for this purpose. In this procedure a strip of Gore-Tex (5 mm wide, 0.6mm thick, and of variable length) is introduced between the inner perichondrium and the thyroid lamina to achieve the desired position of the true vocal cord. Seven patients with unilateral vocal cord paralysis and severe breathiness underwent this procedure. All patients had preoperative and postoperative videostroboscopy and perceptual ratings. Postoperative improvement was observed in all patients. Improvements included increased glottic closure, improved mucosal wave, and decreased breathiness. No patient had any postoperative complications. This technique appears to be simpler and quicker than the conventional Silastic implant procedure, and yields excellent functional results.