HYDROXYLAPATITE LARYNGEAL IMPLANTS FOR MEDIALIZATION - PRELIMINARY-REPORT

Laryngeal implantation for medialization has improved our ability to m anage the patient with vocal fold motion impairment. We present prelim inary data evaluating the use of preformed hydroxylapatite laryngeal i mplants and instrumentation for rapid determination of implant size an d position. A window in the thyroid ala is created by means of a stand ard fenestra template. One of 5 prosthesis templates is inserted throu gh the window for determination of correct size and position. The corr esponding implant is then inserted and secured with a hydroxylapatite shim. Thirty-five patients have been implanted for vocal fold paralysi s, and 4 patients were implanted for soft tissue deficits or bowing. T hirty-one of 35 patients have reported subjective improvement (89%). I mprovement was demonstrated in 13 of 15 (87%) patients with complete p reoperative and postoperative objective voice function measurements. C omplications include 1 implant extrusion and 1 case of airway obstruct ion secondary to edema. Preliminary results indicate that prefabricate d hydroxylapatite implants are effective for medialization thyroplasty . Advantages include a readily available implant selection, rapid dete rmination of correct size and position, and improved implant stabiliza tion with a hydroxylapatite shim.