Feasibility study of laryngeal mask airway-based general anesthesia for medialization thyroplasty with an adjustable implant: clinical and voice outcomes.

PURPOSE: This study aimed to assess the feasibility and voice outcomes of medialization thyroplasty (MT) with the APrevent® Vocal implant system (VOIS) performed under general anesthesia with Ambu® laryngeal mask airway (LMA) and use intraoperative flexible videoendoscope-guided implant balloon adjustment. METHOD: This prospective case series was conducted at a single tertiary referral center. Twelve adult patients with unilateral vocal fold paralysis (UVFP) and severe dysphonia (Voice Handicap Index-30 ≥ 33) underwent MT with the APrevent® VOIS under general anesthesia with LMA, followed by intraoperative flexible videoendoscope-guided implant balloon adjustment to optimize the medialization of paralyzed vocal fold and minimize the glottal gap. Objective voice outcomes and acoustic parameters were evaluated preoperatively and at defined postoperative intervals. RESULTS: All the patients were follow-up to 6 months and the results revealed significant voice improvements. Maximum phonation time increased within two weeks. Voice Handicap Index and cepstral peak prominence smoothed (CPPS) significantly improved at two months. Shimmer and signal-to-noise ratio improved at six months, while jitter showed minimal change. CONCLUSION: MT with the APrevent® VOIS under general anesthesia with LMA and intraoperative flexible videoendoscope-guided implant adjustment is feasible and yields favorable voice outcomes in UVFP patients.