Thyroplasty type I under general anaesthesia with the use of the laryngeal mask and a waking period to assess voice.

Abstract Objective To evaluate a modified technique of type I thyroplasty using general anaesthetic with a laryngeal mask and then local anaesthetic. Methods General anaesthesia with a laryngeal mask is used while the delicate marking and windowing of the thyroid cartilage occurs. The patient is then woken, so that vocalisation can be associated to direct visualization with flexible scope to determine the size of prosthesis used to optimise vocal outcome. Results This modified technique was used in three patients where sedation would be unacceptable. All patients exhibited an improved voice post operatively. The mean maximum phonation time rose to 9.6, 10.6 and 9.3 s from 4.3, 4.6 and 5.3 s. Conclusion Using sedation for type I thyroplasty is not safe or acceptable in some patient groups. Using general anaesthetic with a laryngeal mask and then a shorter local anaesthetic provides a safe and effective alternative.