Titanium Vocal Fold Medializing Implant: Introducing a Novel Implant System for External Vocal Fold Medialization

Abstract

With the increasing worldwide spread of the Isshiki technique for external vocal fold medialization, some disadvantages and limitations have also emerged, and an increasing demand for a ready-made and standardized implant system can be observed. For this reason, I started experimental and clinical investigations with the goal of replacing the silicone with a safer material, and also simplifying and standardizing the surgical procedure. In particular, the danger of implant dislocation should be excluded with greater certainty. As a result, I have developed an implant made of medical-grade titanium. My surgical experiences in 20 patients with this newly developed titanium vocal fold medializing implant revealed that vocal fold medialization could be performed easily and that no perioperative complications occurred in any case. The major advantage was a significant reduction of operative time due to the preformed implant. This is not only more convenient for both the surgeon and the patient, but is also critical for obtaining optimal results due to the reduced intralaryngeal swelling and hematoma. The reduction of the glottic gap by the operation was statistically significant. Significant improvement of all voice parameters was achieved and demonstrated by a statistically significant reduction of the voice dysfunction index. Compared to the current techniques and implant systems, I see the following additional advantages: 1) titanium is a relatively safe implant material with excellent biocompatibility; 2) the design of the implant ensures optimal fixation and stabilization; 3) the implantation technique and handling is simple and time-saving; 4) the titanium sheet is easy to shape and adapt to the individual situation; and 5) only 2 sizes of implants, and no expensive instruments, are required.