Thyroplasty type I under general anaesthesia with the use of the laryngeal mask and a waking period to assess voice

Objective: To evaluate a modified technique of type I thyroplasty using general anaesthetic with a laryngeal mask and then local anaesthetic. Methods: General anaesthesia with a laryngeal mask is used while the delicate marking and windowing of the thyroid cartilage occurs. The patient is then woken, so that vocalisation can be associated to direct visualization with flexible scope to determine the size of prosthesis used to optimise vocal outcome. Results: This modified technique was used in three patients where sedation would be unacceptable. All patients exhibited an improved voice post operatively. The mean maximum phonation time rose to 9.6, 10.6 and 9.3 s from 4.3, 4.6 and 5.3 s. Conclusion: Using sedation for type I thyroplasty is not sale or acceptable in some patient groups. Using general anaesthetic with a laryngeal mask and then a shorter local anaesthetic provides a safe and effective alternative. (C) 2009 Elsevier Ireland Ltd. All rights reserved.