How I do it: miniplate reconstruction of the lateral thyroid lamina: one-stage restoration of voice after teflon granuloma resection.
This case report describes a one-stage technique for long-term voice restoration and laryngeal reconstruction in the treatment of Teflon (Dupont, Wilmington, Delaware) granuloma. A patient who presented with severe dysphonia underwent resection of a Teflon granuloma via a lateral laryngotomy. A pedicled strap muscle flap was used to reconstruct the paraglottic space. The muscle flap was positioned through the lateral laryngotomy with direct endoscopic visualization of the endolarynx to ensure correct vertical positioning and medialization of the vocal fold. The muscle flap was secured in this position with suture fixation. The trapdoor piece of cartilage that was elevated to create the window in the lateral thyroid lamina was repositioned over the pedicled muscle flap and reinforced with a titanium miniplate, which was secured to the remaining thyroid cartilage. The patient had excellent voice results and has not required revision or augmentation. Reinforcement of the lateral thyroid lamina using titanium miniplate fixation helps to stabilize the muscle pedicle flap and the position of the vocal fold, in this case resulting in good long-term voice results after a single-stage reconstruction.
Heman-Ackah
Yolanda D
YD
American Institute for Voice and Ear Research and Departmentsof Otolaryngology--Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA 19103, USA. phillyvoicemd@aol.com
D005260:Female; D006102:Granuloma, Laryngeal / Q000139:chemically induced / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000009:adverse effects* / Q000627:therapeutic use; D011183:Postoperative Complications; D061226:Recurrent Laryngeal Nerve Injuries; D013524:Surgical Flaps; D013957:Thyroid Cartilage / Q000601:surgery; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014832:Voice Disorders / Q000209:etiology / Q000628:therapy
D011138:Polytetrafluoroethylene