Our Summary

Type 1 thyroplasty is a surgical procedure used to treat vocal fold paralysis, a condition that can affect a person’s ability to speak and swallow. This study looked at the safety of performing this surgery on an outpatient basis, meaning patients go home the same day rather than staying overnight in the hospital.

The research team reviewed the medical records of patients who had this procedure at their hospital between 2013 and 2018. They looked at factors like the cause of the paralysis, other health conditions the patients had, and their age and gender. They were specifically interested in any complications that occurred after the surgery, whether patients had to be readmitted to the hospital, and if any needed to have the surgery done again.

The study included 160 patients, with an average age of 62. About half were male and half were female. After the surgery, about 6% of patients had major complications, and about 4% had to be readmitted to the hospital. The complications didn’t happen right away - on average, they occurred about a week after the surgery. None of the patients had problems with their airway after the surgery that required further intervention, and no patients died. About 14% of patients needed to have the surgery done again.

The researchers concluded that it seems safe to perform this surgery on an outpatient basis for patients who are otherwise medically stable. The complications that occurred tended to happen some days after the surgery, rather than immediately afterwards, which suggests that keeping patients in the hospital overnight isn’t necessarily beneficial.

FAQs

  1. What is the safety profile of outpatient Type 1 thyroplasty for vocal fold paralysis?
  2. What were the recorded complications and readmission rates for patients undergoing outpatient Type 1 thyroplasty?
  3. How often was a revision surgery required following the initial Type 1 thyroplasty procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vocal cord surgery is to follow post-operative care instructions carefully, including voice rest, avoiding strain on the vocal cords, and attending follow-up appointments for monitoring and potential further treatment. It is also important to report any unusual symptoms or complications to your healthcare provider promptly.

Suitable For

Patients who are typically recommended vocal cord surgery, specifically type 1 thyroplasty for vocal fold paralysis, are those who are medically stable and have not responded to conservative treatments such as voice therapy. These patients may experience symptoms such as hoarseness, breathiness, vocal fatigue, and difficulty swallowing due to vocal cord paralysis. The decision to undergo surgery is often made after a thorough evaluation by an otolaryngologist, including a laryngoscopy to assess vocal cord function. Patients with certain comorbidities such as cardiovascular disease or diabetes may require additional evaluation and management to ensure safety during surgery. Overall, the goal of vocal cord surgery is to improve voice and swallowing function and quality of life for patients with vocal fold paralysis.

Timeline

  • Before vocal cord surgery: Patients will typically undergo a thorough evaluation by an otolaryngologist to determine the underlying cause of vocal fold paralysis and assess their candidacy for surgery. This may include imaging studies, such as laryngoscopy. Patients will also receive pre-operative counseling and education about the procedure, potential risks, and expected outcomes.

  • Day of surgery: Patients will arrive at the surgical center or hospital and undergo the type 1 thyroplasty procedure under general anesthesia. The surgery involves implanting a silicone or hydroxyapatite implant to medialize the paralyzed vocal fold, improving vocal function and swallowing. The procedure usually takes 1-2 hours.

  • After surgery: Patients will be monitored in the recovery room for a few hours before being discharged home the same day. They will be prescribed pain medication and instructed on post-operative care, including voice rest and avoiding strenuous activities. Patients will follow up with their surgeon for post-operative appointments to monitor healing and voice function.

  • Weeks to months after surgery: Patients will gradually resume normal activities and may undergo voice therapy to optimize vocal outcomes. Some patients may require revision surgery if there are persistent issues with voice or swallowing function. Overall, the goal of vocal cord surgery is to improve voice quality and swallowing function in patients with vocal fold paralysis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vocal cord surgery?
  2. What is the success rate of type 1 thyroplasty for treating vocal fold paralysis?
  3. How long is the recovery time after vocal cord surgery?
  4. What can I expect in terms of voice and swallowing outcomes after the surgery?
  5. Are there any specific postoperative care instructions I should follow?
  6. What factors may increase the likelihood of needing revision surgery after vocal cord surgery?
  7. Will I be able to speak and swallow normally after the surgery?
  8. How soon after the surgery can I resume normal activities, such as talking and eating?
  9. Are there any limitations or restrictions I should be aware of after vocal cord surgery?
  10. Is there a possibility of needing further treatment or therapy after vocal cord surgery?

Reference

Authors: Patel J, Boon M, Spiegel J, Huntley C. Journal: Ear Nose Throat J. 2021 Sep;100(5_suppl):608S-613S. doi: 10.1177/0145561319894414. Epub 2020 Jan 5. PMID: 31903781