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Highlights
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 or voice box in order 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
1. Thyroid cartilage |
medialization thyroplasty or implant medialization |
2. Arytenoid cartilage |
arytenoid adduction
arytenoid arytenopexy |
3. Cricothyroid cartilage |
cricothyroid approximation
cricothyroid subluxation |
Major Advantage
Since the laryngeal framework procedures are done with the patient awake but sedated and not feeling any pain, a major advantage of laryngeal framework surgery is that it allows the voice surgeon to make intraoperative adjustments in order to achieve optimal vocal fold function and voice.
Patients
Patients with voice disorders from vocal fold paresis, vocal fold paralysis, or tissue loss after cancer resection, may benefit from laryngeal framework surgery.
Need for Voice Therapy
Most patients who require laryngeal framework surgery also require post-surgical voice therapy.
Working Philosophy
In order 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 or paralysis or tissue loss (cancer removal).
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