Therapy of insufficient glottic closure = Zdravljenje nepopolne zapore glasilk
Friedrich, Gerhardt
Glottic insufficiency is one of the most common causes for voice disorders. The basic principle of all phonosurgical methods is the medialization of the paralyzed vocal fold. In order to create a ...complete glottic closure, Isshiki in the 1970 took up the Payr's idea of the external vocal fold medialization, modified and systematized it as Laryngeal Framework Surgery and Thyreoplasty Type I. respectively. We started with this technique 1991 and in accordance with numerous reports in literature our own results have been satisfactory. Nevertheless, similar to other authors, we experienced some disadvantages and limitations of the "Isshiki method" concerning both the implant and the surgical technique. For these resons we developed in collaboration with the Heinz Kurz Company, Dusslinger, Germany, an implant made of medical-grade titanium (Titanium Vocal Fold Medializing Implant; TVFMI). Our clinical results in up to now 122 patients show evidence that an external vocal fold medialization can be performed easily and without complications. The functional results are, in accordance with statements in the literature, good and stable. We see the following distinct advantages of the external approach:it is reversible and can be corrected; it can be combined with other phonosurgical approaches; it is also applicable in mobile vocal folds; it enables intraoperative fine-tuning and the results are good and permanent. Thedisadvantages are that the surgical procedure is more time consuming and laborious, and result in a visible scar. (Abstract truncated at 2000 characters)
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