title: Anterior and posterior medialization (APM) thyroplasty.
abstract: OBJECTIVE
  In unilateral vocal fold paralysis with dysphonia, most of the paralyzed vocal folds may be medialized effectively by medialization laryngoplasty. However, if the posterior glottal gap is wide, these procedures may sometimes have a limit to medialize the posterior glottis and cannot be effective for acceptable voice quality. The objective of this study is to introduce a new surgical technique for medializing the membranous and cartilaginous portions of the paralyzed vocal fold: anterior and posterior medialization (APM) thyroplasty.
  
  
  METHODS
  Six patients underwent APM thyroplasty. They completed preoperative and postoperative evaluation with acoustic analysis and video laryngoscopy.
  
  
  RESULTS
  All patients satisfied their voice subjectively after surgery. The paralyzed vocal folds, membranous and cartilaginous parts, were medialized well, and the paralyzed arytenoid showed less anterior tipping postoperatively. On voice analysis all patients showed prolonged phonation times and decreased perturbations after surgery.
  
  
  CONCLUSIONS
  The advantages of this procedure are to medialize the membranous and cartilaginous portions of the paralyzed vocal fold directly and to correct vertical mismatch between two vocal folds. This procedure might be especially indicated in the lateralized position of the paralyzed vocal fold but not in the higher paralyzed vocal fold compared with the normal vocal fold.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Chonbuk National University, Medical School, Chonju, Chonbuk 560-712, Korea. khhong@moak.chonbuk.ac.kr
authors.forename: K H
authors.initials: KH
authors.lastname: Hong
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.forename: H K
authors.initials: HK
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D019736:Prostheses and Implants; D013957:Thyroid Cartilage / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000601:surgery*