Thyroplasty, Arytenoid Adduction, Injection Laryngoplasty

Thyroplasty, arytenoid adduction, and injection laryngoplasty are surgical procedures to move a paralyzed or weak vocal fold (cord) closer to the center of the larynx in order to improve the voice. Thyroplasty is accomplished by placing either a goretex or plastic implant between the cartilage of the larynx (the “Adam’s Apple) and the vocal fold. Arytenoid adduction is accomplished by rotating the cartilage to which the vocal fold is attached. Injection laryngoplasty is accomplished by injecting a substance into the vocal fold.

Vocal Fold Medialization After Surgery Care

Incision: If there is an incision in your neck, this will be covered with skin glue. You will need to keep this dry for 5 days. When you shower, cover this with a bandage, then remove the bandage after the shower and pat the incision dry. After the 5th day, you can shower normally and let the incision get wet. After the shower cover the incision with facial moisturizer or antibiotic ointment and rub in softly, do not produce pain. This will help the incision heal without scar tissue.

Drain: If there is a drain present, you will be asked to return to the office the following day for removal. Keep the drain site dry and do not get it wet in the shower.

Sleeping: Please sleep with your head and upper body elevated to 30 degrees on pillows.

Activity: Do not strain, do heavy lifting or hard exercise that involves the upper body for 2 weeks. This is to avoid putting pressure on your larynx as this could cause the larynx to break after the surgery.

Diet: You can eat your regular diet. However, the first night after anesthesia, it is best to keep your diet light to avoid nausea.

Voice Use: In general you can speak when needed. Your voice will be hoarse or rough in a different way than before surgery. This will last for 2 to 4 weeks. Please do not push to produce voice. If it is too effortful, then limit your speaking.

Pain: Most patients find that regular Tylenol is effective to control pain. There will be a narcotic pain medication called in to your pharmacy that you should pick up to have on hand to use if the acetaminophen is not adequate.

Do not drive, operate dangerous machinery, or do anything dangerous if you are taking narcotic pain medication (such as oxycodone, hydrocodone, morphine, etc.) This medication affects your reflexes and responses, just like alcohol.

Antibiotics: You will be prescribed antibiotics for 5 days if an implant has been left in your larynx. Please follow the instructions on the bottle for use.

Call Your Surgeon If You Have…

1. Any concerns. We would much rather that you call your surgeon then worry at home, or get into trouble.
2. Fever over 101.5 degrees F.
3. Foul smelling discharge from your incision.
4. More than expected swelling of your neck.
5. Increase warmth or redness around the incision.
6. Pain that continues to increase instead of decrease.
7. Problem urinating.
8. If you have trouble breathing- you need to go directly to the emergency room without calling.

How to Call Your Surgeon

1. If it is urgent due to bleeding or difficulty breathing, call 911 or go directly to the closest emergency room without calling ahead.
2. If it is not urgent, please try to call the Laryngology office during clinic hours of 9 am to 5 pm, Monday-Friday. If you need to speak with someone after 5 pm or on a weekend, call the Laryngology office and the answering service will contact the doctor on-call to call you back.

Surgeon:
Mark Courey
9am - 5pm: 
After 5pm & Weekends:
(212) 241-9425

Surgeon: 
Matthew Mori
9am - 5pm: 
Laryngology Office (212) 241-9425
After 5pm & Weekends:
(212) 241-9425

** Please call during office hours for questions related to appointments, prescription refills and lab results. **

Postoperative Appointments

These appointments will have been made for 3 months following the surgery. They will have been given to you with your preoperative packet of instructions. If you have misplaced this list of appointments, in general the first postoperative appointment is 6 days after your surgery. Please call the office to confirm this appointment. We will then provide the list of additional appointment dates at that visit.