Patients with vocal fold paralysis can have atrophy or bowing of the paralyzed vocal fold, leading to poor vocal fold closure and a weak voice. Thyroplasty helps push the vocal fold over for better vocal fold closure and a stronger voice.

In thyroplasty, an implant (like a tiny shim) is placed through the thyroid cartilage (voice box) and behind the vocal fold itself.

Other names for this procedure are "medialization laryngoplasty" or "laryngeal framework surgery."

This procedure requires a small incision in the midline of the neck. The surgeon then drills a small hole through the thyroid cartilage and places the implant on the inside of the thyroid cartilage, pushing the vocal cord over for better closure.

To check the new position of the vocal fold, the surgeon may perform flexible laryngoscopy to assess the exact placement of the implant for best vocal fold closure.

The patient is awake but under local anesthesia as the surgeon asks the patient to speak so the voice quality can be assessed. The surgeon may try different sizes of implants and different placements, listening carefully for the best voice quality.

Patients who have this procedure may experience a sore throat, as well as some minor neck pain and swelling after the procedure.

Postoperative Instructions

Since there is usually some swelling of the vocal folds after the procedure is performed, you will be asked to use a confidential voice for one week. A confidential voice is the volume and quality of voice that you would use in talking to a close friend in a crowded area about a personal topic -- a soft voice -- but not whispering.

During the week after surgery, you should apply antibiotic ointment and take the prescribed medicines as instructed. It is important to stay well hydrated and take any medications as directed by your doctor.

When you return in approximately one to three weeks, you will begin working with the speech pathologist in voice therapy to maximize your voice results. Maximal voice improvement is generally accomplished within one month after the surgery.

This article is intended as a resource for patients receiving their voice care at Duke Voice Care Center. It is not intended to substitute for medical advice from your health care team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.