Anatomic study for posterior medialization thyroplasty

To attain posterior medialization by thyroplasty type I, we simulated the s urgery using 3 cadaveric larynges. Two approaches were applied to adduct th e arytenoid cartilage: one involved compression of the vocal process, and t he other, compression of the muscular process inward. The inner perichondri um was incised to reach the arytenoid cartilage from the framework. To comp ress the vocal process, a large silicons plug was required. In this method, there was some difficulty in compressing the vocal process precisely, and there was the risk of postoperative extrusion of the large plug. In contras t, the muscular process was more superficial relative to the framework, and it could be precisely compressed, resulting in sufficient posterior glotta l closure. The silicone plug required for this procedure has a shallow dept h that may provide the advantage of preventing postoperative extrusion. In conclusion, the compression of the muscular process is preferable for safel y achieving posterior glottal closure.