Experience with Medialization of the Vocal Cords during Treat-ment of Insufficiency of the True Glottis - Introduction to the Problem and History

Overview

The authors present an account of the historical development of surgical operationsperformed to improve the insufficiency of the true glottis. Two basic trends are followed up: surgeryof the laryngeal skeleton and injections of the vocal cords and their augmentation. In 1911 for thefirst time injection of paraffin into the vocal cord was described by Brüningsen, subsequently forinjection and augmentation sesame oil, was used, gelation, glycerin, paste prepared from deprotei-nated bone, cartilaginous suspension, tantal paste, teflon paste, Gelfoam, collagen, Hydron, fathyaluronic acid. The history of surgical operations on the laryngeal skeleton started in 1915 whenPayr described medialization of the vocal cord by prying the cartilagenous lobe of the thyroidcartilage into the larynx. Further development involved in particular modifications of the accessinto the larynx using prostheses of different shapes and from different materials. Carti lage was usedas well as hydroxyl apatite. At present the most widely used material is silastik. Isshiki describedmedialization of the vocal cord by implantation of a silastic prosthesis as thyroplasty type 1 andextended possibilities as regards rotation and adduction of the arytenoid tuberosity.

Key words:
phonosurgery, medialization of the vocal cords, history.