Medialization thyroplasty window creation using an ultrasonic surgical aspirator.

Objectives/hypothesis: The aim of the study was to investigate the use of an ultrasonic surgical aspirator for creation of the laryngeal cartilage window during medialization thyroplasty.

Study Design: Basic science.

Methods: Forty thyroplasty windows were constructed in fresh, unpreserved cadaver larynges. A 6 x 13-mm rectangular window and a 4 x 4-mm round window were created on each side of the larynges in a symmetrical fashion. A standard surgical drill with a 3-mm cutting burr was used on one side; the ultrasonic surgical aspirator was used on the contralateral side. The time required for window construction was recorded, as was the status of the inner perichondrium at window completion.

Results: For creation of the 6 x 13-mm window, a mean time of 128 seconds was required using a standard surgical drill. The mean time using the ultrasonic aspirator device was 91 seconds for the window of the same size (P < .008). For the 4-mm round window, drilling completed the task in a mean time of 63 seconds, compared with 40 seconds (P < .016) for the ultrasonic aspirator. On creation of the 6 x 13-mm window, there were 4 of 10 perichondrial violations in the drilled specimens, and there were no violations in creation of the window of the same size with the ultrasonic aspirator (P = .12). The 4-mm round window had no perichondrium violations in the standard drill group and only 1 of 10 violations in the ultrasonic aspirator group (P = .99).

Conclusion: The study suggested that the ultrasonic surgical aspirator device may be an effective, efficient alternative to the standard drill for medialization thyroplasty window creation. Prospective clinical trials are warranted to better characterize its applicability.