Thyroplasty type I under general anaesthesia with the use of the laryngeal mask and a waking period to assess voice.
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.
Sproson
Eleanor
E
Department of ENT, Queen Alexandra Hospital, Portsmouth, United Kingdom. e.sproson@doctors.org.uk
Nightingale
Jeremy
J
Puxeddu
Roberto
R
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*