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Highlights
 Key Glossary Terms Laryngeal Framework Surgery
Surgical
modification of the cartilage framework of the voice box so vocal folds
can close better or have more tension, which allows vocal folds to
vibrate better for sound production
Laryngeal Framework
Cartilages of voice box: thyroid cartilage, left and right arytenoid cartilages, cricothyroid cartilage
Types of Laryngeal Framework Surgical Procedures
- Medialization thyroplasty/laryngoplasty (implant medialization)
- Arytenoid repositioning (arytenoid adduction or adduction arytenopexy)
- Crico-thyroid repositioning (approximation or subluxation)
In Brief
Improve vocal fold closure to improve vocal fold vibration = better voice function
Laryngeal framework surgery is one form of phonosurgery wherein a voice surgeon makes changes to the "cartilage framework" of the larynx (voice box).
The intent is to improve the position and/or contour of one or both
vocal folds so they close better in order to vibrate better during
speaking or singing – but without hindering passage of air for
breathing.
Other Terminology
Laryngeal framework surgery or laryngoplastic phonosurgery
Voice Box Cartilage and Type of Procedure
- Thyroid cartilage: Medialization thyroplasty/laryngoplasty or implant medialization
- Arytenoid cartilage: Arytenoid adduction, arytenoid arytenopexy
- Cricoid cartilage: Crico-thyroid approximation, crico-thyroid subluxation
Major Advantage
Laryngeal framework surgery is typically done with the patient awake
but sedated and not feeling any pain. A major advantage of this is that
it allows the voice surgeon to make intraoperative adjustments to
achieve optimal vocal fold function and voice.
Patients
Patients with voice disorders from vocal fold paresis, vocal fold
paralysis, or tissue loss – such as might occur after cancer resection
– may benefit from laryngeal framework surgery.
Need for Voice Therapy
Some patients who require laryngeal framework surgery also require postsurgical voice therapy to achieve the best result.
Working Philosophy
To improve voice the surgeon must reposition or shape the abnormal
vocal fold so that the other, non-involved vocal fold can meet it to
reestablish closure for better vibration – but without compromising air
passage.
Working Perspective
Increased understanding of voice function and new procedures have
allowed laryngeal framework surgery to become an effective treatment
option for patients with certain voice disorders that are due to
paresis, paralysis, or tissue loss.
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