Type I thyroplasty: A safe outpatient procedure
Attapon Junlapan MD  C. Kwang Sung MD, MS  Edward J. Damrose MD
First published: 24 December 2018 https://doi.org/10.1002/lary.27686
Presented at the 139th Annual Meeting of the American Laryngological Association at the Combined Otolaryngological Spring Meetings, National Harbor, Maryland, U.S.A., April 18–22, 2018.
The authors have no funding, financial relationships, or conflicts of interest to disclose.
Read the full text
ePDFPDFTOOLS SHARE
Abstract
Objectives/Hypothesis
Overnight hospitalization is routinely advocated following type I thyroplasty (TP) because of concerns for airway compromise. Hospitalization increases cost and patient inconvenience, and may not necessarily be appropriate. This study evaluated complications following surgery and identified predictors for same to assess which patients benefit most from hospitalization.

Study Design
Retrospective chart review.

Methods
A study was conducted on patients who underwent TP with or without arytenoid repositioning procedures between June 2008 and March 2017. The demographic data of the subjects, characteristics, etiology of glottic insufficiency, interventions performed, and subsequent complications were evaluated.

Results
Of 147 patients reviewed, 100 underwent TP alone, 41 underwent TP with arytenoid adduction, and six patients underwent TP with adduction arytenopexy. Iatrogenic vocal fold paralysis was the most common indication. Major complications, which included transient airway compromise and hematoma requiring reoperation, occurred in 7% of patients. Revision surgery and thyroplasty combined with arytenoid repositioning maneuvers were associated with increased risk of major complications.

Conclusions
In general, TP is a safe procedure, with a major complication rate that is lower than that of outpatient thyroidectomy. Overnight hospitalization should be considered in patients undergoing revision surgery and in those requiring concurrent arytenoid repositioning procedures.

Level of Evidence
4

Laryngoscope, 129:1640–1646, 2019