Use of the montgomery implant system in medialization thyroplasty: postoperative vocal outcomes

Objective: Medialization thyroplasty using the Montgomery® Implant System (MTIS) is a surgical procedure for the treatment of persistent glottal gaps. In this study, we aimed to analyze postoperative vocal outcomes in patients suffering from unilateral vocal fold paralysis. Methods: A retrospective study was conducted on 30 patients undergoing MTIS medialization thyroplasty for unilateral vocal fold immobility. This series was selected from 68 patients operated on by the same technique between 2009 and 2018. Patients with missing data were excluded. The surgical procedure was performed under local anesthesia and sedation with peroperative fiberoptic examination. A complete vocal assessment was undertaken pre- and postoperatively, including perceptual, aerodynamic, and acoustic parameters and a questionnaire. Short-term outcomes were analyzed. Results: Postoperative assessment was performed at a median of 33 days (range eight to 216). Absolute median maximum phonation time showed an increase of 4.10 seconds (p < 0.05), whereas the voice handicap index decreased by 36 points (p < 0.05). No significant differences were found between sexes. Conclusion: This retrospective study confirms the excellent immediate vocal results after medialization thyroplasty using MTIS. Further studies with prospective data are needed to evaluate the results according to sex of the patient.