The Stroke Network, Inc )

Thyroplasty Surgery

By Debbie Batjer

 

Getting My Voice Back

 

In 1993, surgery to remove a benign meningioma resulted in a brainstem stroke. One of my vocal chords was paralyzed in an open position. Whatever utterances I generated were breathy and whispery – or, if fatigued, nonexistent.

When my other many deficits had either stabilized or improved, frustration with my voice – or lack thereof – grew. In social situations I could not be heard over the normal din of many conversations around me. The resulting isolation was intolerable. I could not shout, sing, exclaim or be heard. The only upside was that our three kids told me they liked my soft-spoken-ness better! That aside, I hated it.

Several folks, including my speech therapist and this site’s Steve Mallory, told me about a surgery called thyroplasty. They suggested I investigate. (I have since learned that this is also called laryngeal framework surgery.) Basically, thryoplasty shims (with an inert solid material) my paralyzed vocal chord up to the midline position. This would provide a narrow opening for air to pass between it and my other functioning chord, thereby resonating to create sound. Until 1997, I was afraid of more surgery, but by then I was ready.

We (I include my patient husband) found a voice specialist at the University of Washington, who, after examining me, said I would be a good candidate for a surgical procedure called thryoplasty with arytenoid adduction. He did caution that 50% of my airway would be permanently closed, limiting my tolerance for physical exertion. It was important, he insisted, to make my airway reduction known to medical professionals before they administered any future anesthesia. Knowing this, we scheduled the procedure.

The goal was to replicate as nearly as possible my pre-stroke voice. The shim was to be inserted and manipulated through a small incision in my neck. Staying awake throughout surgery was important, to enable the surgeon to adjust the shim as I responded orally to his prompts. A local anesthesia obviously obliterated any discomfort and I actually enjoyed making audible sounds for the first time in over four years. The surgery took between two and three hours. Results were instantaneous.

I came home from the hospital the next day. One of the first things I did was replace my husband’s recorded message on our phone answering machine with my “new” strong voice.

I still cannot sing. When I exercise, predictably I do get winded more readily than I did pre-surgery.

Nonetheless, it is oh-so-nice to be able to project a voice that can easily be heard

 


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