THYROPLASTY TYPE-I WITH CERAMIC SHIM

To prevent side effects from a silicone shim in Isshiki thyroplasty ty pe I, we used a ceramic shim in 10 patients with unilateral recurrent laryngeal nerve paralysis. No published reports have described the use of ce ramic in this type of surgery. According to the degree of glott ic insufficiency, ceramic shims of various heights were inserted into the fenestration made in the thyroid ala. All patients experienced sub jective improvement of voice postoperatively. Laryngoscopies in most c ases showed that glottic insufficiency improved postoperatively. In th e postoperative examination, the maximum phonation time improved an av erage of 3.7 s, and the mean flow rate improved an average of 331 ml/s . We have analyzed the relationship of these improvements to the degre e of glottic insufficiency and have compared our results with those of other investigators.