Laryngeal framework surgery can change the position and tension of the vocal folds safely without direct surgical intervention in the vocal fold proper. Some 23 years of experience with phonosurgery have proved its usefulness in treating dysphonia related to unilateral vocal fold paralysis, vocal fold atrophy, and pitch-related dysphonias. Meanwhile, much information about the mechanism of voice production has been obtained through intraoperative findings of voice and fiberscopic examination of the larynx. Based on such knowledge together with information obtained through model experiments, the human vocal organ was reconsidered mainly from the mechanical view point, and the roles of voice therapy and singing pedagogy were discussed in relation to phonosurgery. The vocal organ may not be an ideal musical organ and is rather vulnerable, but its potential is enormous.
Get full access to this article
View all access options for this article.
References
1.
IsshikiNMoritaHOkamuraHThyroplasty as a new phonosurgical technique. Acta Otolaryngol1974; 78:451–7.
2.
IsshikiN.Recent advances in phonosurgery. Folia Phoniatr1980; 32:119–54.
3.
IsshikiN.Phonosurgery: theory, and practice. Tokyo: Springer-Verlag; 1989. p. 1–233.
4.
AdamsSGIrishJCDurkinLCEvaluation of vocal function in unilateral vocal fold paralysis following thyroplastic surgery. J Otolaryngol1996; 25:165–70.
5.
BielamowiczSBerkeGSAn improved method of medialization laryngoplasty using a three-sided thyroplasty window. Laryngoscope1995; 105:537–9.
6.
BryantNJGraccoLCSasakiCTMRI evaluation of vocal fold paralysis before and after type I thyroplasty. Laryngoscope1996; 106:1386–92.
7.
CarrauRLMyersENLocalization of true vocal cord for medialization thyroplasty. Laryngoscope1995; 105:534–6.
8.
CasianoRRRayA.Perichondrial elevator for thyroplasty type I surgery. Otolaryngol Head Neck Surg1994; 110:350–2.
9.
CotterCSAvidanoMACraryMALaryngeal complications after type I thyroplasty. Otolaryngol Head Neck Surg1995; 113:671–3.
10.
CummingsCWPurcellLLFlintPWHydroxylapatite laryngeal implants for medialization: Preliminary report. Ann Otol Rhinol Laryngol1993; 102:843–51.
11.
DelolJMauriceNMakeieffMRole of type I thyroplasty in the treatment of unilateral laryngeal paralysis: Apropos of 19 cases. Rev Laryngol Otol Rhinol1995; 116:293–8.
12.
DesrosiersMAhmaraniCBettezM.Precise vocal cord medialization using an adjustable laryngeal implant: A preliminary study. Otolaryngol Head Neck Surg1993; 109:1014–9.
13.
DonnellyMBrowneJFitzpatrickG.Anaesthesia for thyroplasty. Can J Anaesth1995; 42:813–5.
GuayMEMillerFRBauerTWVocal fold medialization using autologous cartilage in a canine model: A preliminary study. Laryngoscope1995; 105:1049–52.
16.
HarriesMLMorrisonM.Short-term results of laryngeal framework surgery—thyroplasty type I: A pilot study. J Otolaryngol1995; 24:281–7.
17.
IsshikiNOkamuraHIshikawaT.Thyroplasty type I (lateral compression) for dysphonia due to vocal cord paralysis or atrophy. Acta Otolaryngol1975; 80:465–73.
18.
IsshikiNTairaTKojimaHRecent modifications in thyroplasty type I. Ann Otol Rhinol Laryngol1989; 98:777–9.
19.
IsshikiN.Laryngeal framework surgery. In: Advances in otolaryngology-head and neck surgery. Vol 5. St Louis: Mosby; 1991. p. 37–56.
20.
IsshikiN.Laryngoplasty (phonosurgery). In: EnglishGM, editor. Otolaryngology. Vol 3. Philadelphia (PA): Lippincott-Raven; 1995. p. 1–23.
21.
LederSBSasakiCTLong-term changes in vocal quality following Isshiki thyroplasty type I. Laryngoscope1994; 104:275–7.
22.
LeeECKurilloffDBThe pilot hole technique in type I thyroplasty. Laryngoscope1995; 105:768–70.
23.
LuFLCasianoRRLundyDSLongitudinal evaluation of vocal function after thyroplasty type I in the treatment of unilateral vocal paralysis. Laryngoscope1996; 106:573–7.
24.
McKennisATWaddingtonC.Thyroplasty type I for unilateral vocal cord paralysis. AORN J1994; 60:38–42.
25.
MontgomeryWWBlaugrundSMVarvaresMAThyroplasty: A new approach. Ann Otol Rhinol Laryngol1993; 102:571–9.
26.
MontgomeryWWHillmanREVarvaresMACombined thyroplasty type I and inferior constrictor myotomy. Ann Otol Rhinol Laryngol1994; 103:858–62.
27.
NettervilleJLJacksonCGCivantosF.Thyroplasty in the functional rehabilitation of neurotologic skull base surgery patients. Am J Otol1993; 14:460–4.
28.
OmoriKKackerASlavitDHQuantitative videostroboscopic measurement of glottal gap and vocal function: An analysis of thyroplasty type I. Ann Otol Rhinol Laryngol1996; 105:280–5.
29.
OmoriKSlavitDHKacherAQuantitative criteria for predicting thyroplasty type I outcome. Laryngoscope1996; 106:689–93.
30.
RighiPDWilsonKMGluckmanJLThyroplasty using a silicone elastomer implant. Otolaryngol Clin North Am1995; 28:309–16.
31.
RosinghHJDikkersFGThyroplasty to improve the voice in patients with a unilateral vocal fold paralysis. Clin Otolaryngol1995; 20:124–6.
32.
SakaiNFurutaYNishizawaNThyroplasty type I with ceramic shim. Auris Nasus Larynx1993; 20:231–7.
33.
SasakiCTDriscollBPGraccoCThe fate of medialized cartilage in thyroplasty type I. Arch Otolaryngol Head Neck Surg1994; 120:1398–9.
34.
ThompsonDMMaragosNEEdwardsBWThe study of vocal fold vibratory patterns in patients with unilateral vocal fold paralysis before and after type I thyroplasty with or without arytenoid adduction. Laryngoscope1995; 105:481–6.
35.
BielamowiczSBerkeGSGerrattBRA comparison of type I thyroplasty and arytenoid adduction. J Voice1995; 9:466–72.
36.
GacekMGacekRRCricoarytenoid joint mobility after chronic vocal cord paralysis. Laryngoscope1996; 106:1528–30.
37.
IsshikiNTanabeMSawadaM.Arytenoid adduction for unilateral vocal cord paralysis. Arch Otolaryngol1978; 104:555–8.
38.
SlavitDHMaragosNEArytenoid adduction and type I thyroplasty in the treatment of aphonia. J Voice1994; 8:84–91.
39.
IsshikiNShojiKKojimaHVocal fold atrophy and its surgical treatment. Ann Otol Rhinol Laryngol1996; 105:182–8.
40.
IsshikiNYamamotoYAraiM.Dysphonia due to the misplaced arytenoid and its treatment. Presented at the Voice Foundation's 25th Annual Symposium: Care of the Professional Voice and the International Association of Phonosurgeons, June 3-9, 1996, Philadelphia.
41.
MaragosNEType 2 Isshiki thyroplasty in the management of dyspnea in bilateral vocal cord paralysis. In: Proceedings of the 2nd International Symposium on Laryngeal and Tracheal Reconstruction, May 22-26, 1996, Monte-Carlo.
42.
van den BergJWTanTSResults of experiments with human larynges. Pract Otol1959; 21:425–50.
43.
BlaugrundSMTairaTEl-AssuootyAEffect of lateral manual compression upon glottic incompetence—objective evaluations. Ann Otol Rhinol Laryngol1991; 99:249–55.
44.
HajiTIsshikiNMoriKExperimental study of the mobility of the vocal fold mucosa. Folia Phoniatr1991; 43:21–8.
45.
IsshikiNTairaTNoseKSurgical treatment of laryngeal web with mucosa graft. Ann Otol Rhinol Laryngol1991; 100:95–100.
46.
IsshikiNTairaTTanabeM.Surgical alteration of the vocal pitch. J Otolaryngol1983; 12:335–40.
47.
ShawGYSearlJPHooverLADiagnosis and treatment of unilateral cricothyroid muscle paralysis with a modified Isshiki type 4 thyroplasty. Otolaryngol Head Neck Surg1995; 113:679–88.
48.
MahieuHFNorbartTSnelF.Laryngeal framework surgery for voice improvement. Rev Laryngol Otol Rhinol (Bord)1996; 117:189–97.
49.
HuangJ.Experimental investigation of cricothyroid approximation for correction of hoarseness caused by superior laryngeal paralysis. Chung Hua Erh Pi Yen Hou Ko Tsa Chih1991; 26:88–9.
50.
TuckerHMAnterior commissure laryngoplasty for adjustment of vocal fold tension. Ann Otol Rhinol Laryngol1985; 94:547–49.
51.
KitajimaKTanabeMIsshikiN.Cricothyroid distance and vocal pitch. Experimental surgical study to elevate the vocal pitch. Ann Otol Rhinol Laryngol1979; 88:52–5.
