Adjustable laryngeal implant for unilateral vocal cord paralysis.

Background: Laryngeal framework surgery has been widely accepted as a definitive treatment for unilateral vocal cord paralysis (UVCP). An adjustable laryngeal implant has been developed for precise medialization of the paralyzed vocal cord.

Objective: To describe the implant and surgical technique and to evaluate the effect of vocal cord medialization using an adjustable laryngeal implant on the quality of life of patients with UVCP.

Methods: Fifty-three patients with UVCP who had undergone medialization with the adjustable laryngeal implant were identified. All patients completed the Voice Handicap Index (VHI) quality of life questionnaire. Preoperative and postoperative scores were compared.

Results: Major advantages over other accepted implants are the stability of the implant, excellent biocompatibility, precise medialization with a micrometric screw, and ease of secondary adjustment. Mean VHI score in all handicap domains was significantly improved following vocal fold medialization (p < .01). Although no difference was found in regard to gender, younger patients had higher handicap scores than older patients preoperatively (p < .05). This difference was not present following medialization.

Conclusions: The adjustable laryngeal implant offers many advantages over other techniques. Vocal cord medialization using the adjustable laryngeal implant significantly improves quality of life as measured by the VHI.