[Thyroplasty by external approach with silastic prosthesis in the treatment of laryngeal paralysis]. / Thyroplastie par voie externe avec prothèse en silastic dans le traitement des immobilités laryngées.

From August 1995 to January 1997 8 phonosurgical procedures were performed to correct glottal incompetence. There were 4 men and 4 women, the median age was 42 years. The most common indication for thyroplasty was recurrent or vagal nerve injury (6/8 cases). In 7 cases the paralyzed vocal cord was unilateral and in 1 case bilateral after oesophagectomy. Two patients were previously treated by endoscopic injection without success. The procedure was conducted under general anaesthesia. A window in the thyroid ala was created and silastic implant inserted. This technique was indicated to correct large glottal incompetence or in case of failure after endoscopic treatment. There have been no complications. Improvement of post operative voice was noted. The maximum phonation duration, intensity and objective voice measurements were improved in all cases.

[Extracartilaginous glottectomy. Operative technic, indications and results]. / La glottectomie extra-cartilagineuse. Technique opératoire, indications, résultats.

Cancer developing on a chronic laryngitis or bilateral superficial cancer of vocal cords still pose management problems to surgeons. Double cordectomy presents the inconvenience of opening the larynx in the median line and the need for insertion of a dilating piece removed during a second stage. These disadvantages can be avoided by an extracartilaginous glottectomy by median opening of thyroid cartilage, monoblock ablation of both vocal cords and immediate closure of larynx by lowering of ventricular bands. A wide larynx is obtained with a loud but veiled voice.