Medialisation Thyroplasty
Medialisation thyroplasty, also called type I thyroplasty or medialisation laryngoplasty, repositions a paralysed or weak vocal fold using a small implant placed through the voice box framework. It gives a lasting improvement in closure.
What it is
Through a small incision in the neck, a window is made in the thyroid cartilage alongside the affected vocal fold. An implant is shaped and placed through the window to push the fold toward the midline. In selected patients, arytenoid adduction is added to correct the position of the back of the fold.
Who it is for
Patients with unilateral vocal fold paralysis in whom recovery is unlikely or enough time has passed, and some patients with a persistent gap from other causes. It is one of the options weighed in our Vocal Fold Paralysis and Reinnervation program.
What happens
The operation is performed in theatre, usually under local anaesthesia with sedation so that the patient can speak during surgery. The surgeon listens to the voice while adjusting the implant, and chooses the final position by sound as well as by sight.
Recovery and results
Most patients stay in hospital briefly. The voice is often improved at once, then fluctuates for a few weeks as swelling settles, before stabilising. Voice therapy helps consolidate the result.
Risks
As with any neck surgery, risks include bleeding, infection and airway swelling, as well as implant malposition that may need adjustment. These are uncommon and are discussed in detail beforehand.
Medically reviewed by
Associate Professor Necati Enver, MD
Laryngologist · Founder and Director, Istanbul Voice Center · Reviewed September 2026
General information only. It does not replace an individual assessment. Medical disclaimer
Frequently asked questions
Is thyroplasty permanent?
The implant is designed to stay in place, so the repositioning is durable. The voice can still change over time with age or with changes in the other vocal fold.
Why am I awake during thyroplasty?
Keeping the patient awake, under local anaesthesia and sedation, allows the surgeon to listen to the voice while adjusting the implant, so the final position is chosen by sound as well as by sight.
Does thyroplasty prevent future reinnervation?
It does not necessarily, but the order and combination of treatments should be planned from the start. This is one reason to have the full range of options considered together.
Need a specialist voice or laryngeal evaluation?
Tell us briefly what is happening. We reply with the next step, usually within one business day.