Thyroplasty under general anesthesia using a laryngeal mask airway and fibreoptic bronchoscope

Purpose: To report the management of a patient, with unilateral vocal cord paralysis, undergoing thyroplasty, under general anesthesia. Clinical Features: A 25-yr-old man developed hoarseness and occasional epis odes of pulmonary aspiration, caused by unilateral vocal cord paralysis. He was scheduled for thyroplasty, in an attempt to ease phonation and to decr ease or prevent further episodes of pulmonary aspiration. He refused local anesthesia with sedation and it was therefore decided to attempt the proced ure under general anesthesia. The paralysed vocal cord was displaced inward s by a wedge inserted through-a window in the thyroid cartilage. We assesse d the ideal position of the wedge by using a fibreoptic bronchoscope and la ryngeal mask airway during general anesthesia, instead of phonation. Conclusion: We describe the successful use of a general anesthetic for a th yroplasty, a procedure normally done under local anesthesia with or without sedation, in a patient who was keen to have surgery, but who refused local anesthesia with sedation.