In laryngeal framework surgery, the procedure of choice to medialise a paralysed vocal cord without entering the laryngeal lumen is:

• A Injection laryngoplasty with autologous fat
• B Type I thyroplasty (medialisation thyroplasty) with a silastic implant ✓
• C Arytenoid adduction procedure
• D Laser laterofixation of the cord

Explanation

Type I thyroplasty (Isshiki thyroplasty) involves creating a window in the thyroid cartilage and placing an implant (silastic, titanium, or Gore-Tex) through the external approach to push the paralysed cord medially without entering the laryngeal lumen. It is the preferred framework surgery for unilateral vocal cord paralysis causing dysphonia/aspiration and can be performed under local anaesthesia allowing intraoperative voice monitoring. Injection laryngoplasty enters the lumen but is minimally invasive and good for temporary medialisation. Arytenoid adduction is an additional procedure for large posterior glottic gaps.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.