[Montgomery thyroplasty implant under local anesthesia for unilateral XXXX ].

@entity1 @entity4 @entity7364 @entity1410 @entity230 @entity912
OBJECTIVES: Based on an inception cohort of 63 @entity1 with unilateral vocal fold @entity912 consecutively treated with thyroplasty and Montgomery's implant under local anesthesia during the years 1997-2002, we recorded i) morbidity and mortality, ii) evolution of @entity7364 and swallowing impairment and iii) a prospective analysis of selected speech and voice parameters in an attempt to determine their evolution during the first 12 postoperative months and to search for potential statistical relationships with the following variables (age, gender, side of the @entity912 , etiology of the @entity912 , time between onset of @entity912 and thyroplasty, position of the paralyzed true vocal fold, nerve involved, associated pneumonectomy, prior intracordal injection of autologous fat and surgeon). RESULTS: The overall complication rate was 8%. Minor complications occurred in 6.5% of the @entity1 and included 4 cases of @entity4 successfully treated with oral @entity230 . Major complications occurred in 1.5% of the @entity1 . @entity1410 requiring temporary tracheotomy was the major complication. Swallowing was improved in 93.5% of the @entity1 . Immediate improvement of speech and voice was noted in all. Secondary degradation of speech and voice occurred in one @entity1 . At revision thyroplasty lateral displacement of the implant was noted and successfully repositioned. At one month post-operatively, the values of maximum phonation time, speech rate, group phrasing standard deviation of the fundamental frequency, jitter and shimmer were statistically improved while the fundamental frequency did not vary significantly. At 12 months post-operatively the noise to harmonic ratio was improved while the other parameters remained stable. No significant statistical relationship was found between the post-operative speech and voice parameters and the variables under analysis. CONCLUSION: Based on the current series and a review of the medical literature, thyroplasty with Montgomery's implant under local anesthesia appears to be an easy, effective and safe procedure that might be used in all @entity1 with unilateral laryngeal nerve @entity912 .
