Chapter 63 : Medialization Thyroplasty

Question 1

Phonosurgical procedures may be classified as:

Answer 1

a. microlaryngeal procedures for excision of benign or malignant
b. vocal fold injection for augmentation and medialization
c. laryngeal framework surgery
d. laryngeal reinnervation procedures
e. reconstructive and rehabilitative procedures after tumor resection

Question 2

first to introduce the concept of alloplastic implant material for medialization, also first to introduce the arytenoid adduction procedure for unilateral vocal cord paralysis

Answer 2

Nobuhiko Isshiki and associates

IS-SHIKI

Question 3

4 types of surgical procedures on the basis of the functional alteration of the vocal folds

Answer 3

Type I: medial displacement

Type II: lateral displacement

Type III: shortening or relaxation

Type IV: elongation or tensioning, type IV: elongation or tensioning

Question 4

failure of primary nerve repair is ascribed to a random process of axonal regeneration at the site of injury that results in the simultaneous contraction of antagonistic muscle groups

Answer 4

Synkinesis

Question 5

use of this structure for nerve-nerve anastamoisis in unilateral vocal fold paralysis

Answer 5

ansa hypoglossus

Question 6

in the 1960s, Arnold reintroduced vocal fold injection with the use of this alloplastic material

Answer 6

PTFE or Polytetrafluoroethylene

Question 7

this micronized alloderm regenerative tissue matrix was applied for vocal fold injection and early reports indicate improvements in soft tissue response, tissue compliance, and overall phonatory

Answer 7

Cymetra

Question 8

Placement of a suture around the muscular process of the arytenoid with traction in the direc- tion of the lateral cricoarytenoid and thyroarytenoid muscles results in medial rotation of the arytenoid and downward dis- placement of the vocal process. The posterior gap is reduced, and the paralyzed vocal folds are placed at equal levels

Answer 8

artenoid adduction procedure

Question 9

remains to be the most useful subjective and objective test for preoperative and postoperative evaluation of patients with unilateral vocal impairment, and it provices visual assessment of glottal closure and of the status of the mucoasa wave

Answer 9

Videostroboscopy

Question 10

ony test available at this time for evaluating the integrity of the laryngeal motor unit in the presence of vocal fold motion impairment

Answer 10

Electromyography

Question 11

in median thyroplasty, cartilage window is positioned

Answer 11

5 to 8 mm posterior to the ventral midline in women and 8 to 10 mm in men

Question 12

the superior aspect of the cartiage window should be placed at the level of this laryngeal structure. This level is a point half the distance between the anterior-inferior border of the thyroid cartilage and the thyroid notch

Answer 12

true vocal fold

Question 13

TRUE or FALSE

As a rule, regardless of implant type used, it is preferable to use the largest prosthesis possible that maintains quality of voice.

Answer 13

True

Question 14

In 1999, Nishiyama and colleagues described a modification of thyroplasty using this kind of graft

Answer 14

autologous temporalis fascia grafts