title: Thyroplasty type I under general anaesthesia with the use of the laryngeal mask and a waking period to assess voice.
abstract: OBJECTIVE
  To evaluate a modified technique of type I thyroplasty using general anaesthetic with a laryngeal mask and then local anaesthetic.
  
  
  METHODS
  General anaesthesia with a laryngeal mask is used while the delicate marking and windowing of the thyroid cartilage occurs. The patient is then woken, so that vocalisation can be associated to direct visualization with flexible scope to determine the size of prosthesis used to optimise vocal outcome.
  
  
  RESULTS
  This modified technique was used in three patients where sedation would be unacceptable. All patients exhibited an improved voice post operatively. The mean maximum phonation time rose to 9.6, 10.6 and 9.3s from 4.3, 4.6 and 5.3s.
  
  
  CONCLUSIONS
  Using sedation for type I thyroplasty is not safe or acceptable in some patient groups. Using general anaesthetic with a laryngeal mask and then a shorter local anaesthetic provides a safe and effective alternative.
authors.affiliation: Department of ENT, Queen Alexandra Hospital, Portsmouth, United Kingdom. e.sproson@doctors.org.uk
authors.forename: Eleanor
authors.initials: E
authors.lastname: Sproson
authors.forename: Jeremy
authors.initials: J
authors.lastname: Nightingale
authors.forename: Roberto
authors.initials: R
authors.lastname: Puxeddu
mesh_terms: D000368:Aged; D000769:Anesthesia, Inhalation; D005260:Female; D006685:Hoarseness; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation* / Q000592:standards*; D011184:Postoperative Period; D013961:Thyroid Gland / Q000601:surgery*; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D014833:Voice Quality / Q000502:physiology*