A series of thyroplasty cases under general anaesthesia

Abstract

Thyroplasty is an operation on the upper airway to improve voice quality in patients with unilateral vocal cord paralysis. It requires access to an uninstrumented larynx and a functional assessment of vocal cord medialization. It is a difficult anaesthetic procedure that requires sharing the airway with the surgeon. We describe an anaesthetic technique to give good operating conditions and a safe airway, using total intravenous anaesthesia, a laryngeal mask airway and intraoperative fibreoptic endoscopic assessment of the larynx, and present a series of 13 patients. Other anaesthetic techniques for thyroplasty are described and discussed.

Reducing sedation time for thyroplasty with arytenoid adduction with sequential anesthetic technique

“…The current study differs from previous reports of performing TP-AA under GA in one important aspect. Several authors have reported the use of a laryngeal mask airway (LMA) to perform TP-AA or TP alone under GA. [14][15][16][17] In that technique, visualization of the glottis to gauge the degree of vocal fold medialization is provided by a flexible laryngoscope passed through the lumen of the LMA. However, the patient could not vocalize with adjustment of the medialization implant and the tension on the arytenoid adduction suture.…”

The laryngeal mask airway and otorhinolaryngology head and neck surgery

“…The LMA enables the surgeon to view endolaryngeal structures while at the same time operating via an external approach, thereby providing an ideal situation for laryngeal framework surgery 35. This aids in the exact positioning of the vocal fold during medialization surgery in the anesthetized patient.…”

Caveat lector

“…[4], 2 A paragraph in the introduction was copied verbatim from the British Journal of Anesthesia. [5] The figures were taken from two web sites,3,4 and a previously published article from the University of Pittsburg,[6] (which likely explained why the words “Univ of Pittsbu” appear in the figure). As this case series reported patients who never existed at the MP Shah Medical College, it was also fraud.…”