Your Guide to Thyroplasty and Recovery

Several types of thyroplasty can alter or repair the vocal folds. This surgery is typically considered safe, and recovery times are minimal.

A thyroplasty is a surgical procedure done to modify your vocal cords. It’s typically a treatment for dysfunction in your voice or difficulty coughing.

Thyroplasty is considered a safe and common procedure, and you can usually go home the same day. However, there are still some risks and aftercare instructions you should consider.

Read on to learn more about the benefits and risks of thyroplasty and what to expect after the procedure.

What is thyroplasty surgery for?

Thyroplasty is also called laryngoplasty or simply vocal cord surgery. It’s a label for a category of surgeries performed on the vocal cords to either influence the voice or improve respiratory function. This includes:

• Type 1: This is the most common type of thyroplasty. It involves vocal fold medialization, where an implant is placed in a paralyzed vocal cord. This is used to treat unilateral vocal cord paralysis. Arytenoid adduction is an additional procedure that may be performed at the same time.
• Type 2: This is used to separate the vocal folds and is called vocal cord lateralization. This can treat involuntary spasms that can cause the vocal cords to become stiff. This can help improve breathing as well as vocalization.
• Type 3: This involves the shortening or relaxation of the vocal cords. This lowers the voice and is used in voice masculinization surgery.
• Type 4: This is also called cricothyroid approximation and involves the elongation or tensioning of the vocal cord. This can be part of voice feminization surgery.
• Glottoplasty: It can create an anterior glottic web formation on the vocal cords. This is used to intentionally change the sound of the voice in voice feminization surgery.

These surgeries can help with vocal cord paralysis , vocal cord dysfunction , breathing difficulties, or altering the sound of your voice.

Thyroplasty has been used to help singers whose vocal cords are damaged by overuse, misuse, or an accident.

Thyroplasty can also be a part of gender confirmation surgery . Some trans and cis people use types 3 and 4 to change the pitch of their voice to be more in line with their gender identity or presentation.

Possible side effects and complications of thyroplasty

Thyroplasties are generally considered safe and are done in outpatient facilities so that you can go home the same day.

Some of the possible side effects of thyroplasty include:

• pain or soreness in your neck near where the surgery was done
• numbness in the skin around your throat and neck
• temporary hoarseness as your vocal cords recover
• bleeding that’s difficult to control
• the implant could shift and cause changes in vocal quality

Some rare complications of a thyroplasty include:

• major allergic reactions
• infections in or around your vocal cords after surgery
• having trouble swallowing ( dysphagia )
• having trouble breathing because of vocal cord swelling
• stroke
• heart attack

What to expect after thyroplasty

Most of the time, you’ll be awake for the procedure, and local anesthesia will be used. However, for some types and situations, general anesthesia may be used. Talk with your surgical team if you have any concerns about anesthesia.

After a thyroplasty, you’ll have a bandage around your neck. Avoid touching it until a doctor tells you it’s OK. Your surgical team will observe you before you’re discharged to ensure that you can breathe, swallow, and walk around normally.

Make sure to follow the directions your surgical care team gives you carefully, as your recovery may require personalized steps. However, in general, here are some tips to help make your recovery quick and effective:

• Don’t bathe or shower for at least 3 days to avoid interfering with the bandages on your neck.
• Don’t use your voice for at least 3 days after surgery — including whispering, laughing, or talking at a normal volume. You can keep a notebook or dry-erase board handy to make sure you can still communicate with those around you.
• Try to avoid coughing as much as possible. Ask your surgical team what cough remedies they recommend.
• After 3 days, slowly start using your voice without talking too much or raising your voice. Ask your surgical team whether they recommend any vocal warmups for this time.
• After a week, you can usually start using your voice normally again if you don’t experience any pain or discomfort. If you use your voice for any strenuous activity like singing, shouting, or public speaking, ask your surgical team what timeline is best for you.
• Follow a liquid diet to reduce any strain or discomfort in your throat. Return to your regular diet after about a week or when you feel comfortable doing so.
• Take any pain medication that’s prescribed to you to help manage soreness while you’re recovering.
• For at least 2 weeks after surgery, don’t do any strenuous exercise or lift anything heavier than 15 pounds.

You’ll usually visit the doctor or surgeon a week or two after surgery to check on your progress and receive any further aftercare instructions.

Frequently asked questions about thyroplasty

Here are some of the most frequently asked questions about thyroplasty.

What is the success rate of thyroplasty?

Thyroplasties are considered routine and safe surgeries. While complications are possible, the rates are typically low .

A 2020 study of 29 people who underwent thyroplasty found that most of them reported a significant improvement in their perception of their voice quality.

Titanium implants used in thyroplasty sometimes break. However, according to a recent study in 2023 , these fractures are usually small and did not result in statistical differences in the success of the surgeries.

Is thyroplasty painful?

Some pain or soreness is normal after a thyroplasty. The pain should center around the location of the surgery and slowly get better over the course of several days. Your surgical team should provide prescription pain medications to help or give recommendations for the best over-the-counter pain meds for you .

Get immediate medical help if your pain is severe, does not respond to medication, escalates quickly, or causes you to have difficulty breathing or swallowing. Signs of swelling and prolonged pain could indicate an infection .

Is thyroplasty permanent?

Yes, typically, unless further damage is done to the vocal folds, additional surgeries are not needed. However, many of these procedures are reversible if necessary.

Changes to the vocal pitch achieved by thyroplasty are usually permanent effects.

Is thyroplasty covered by insurance or Medicare?

Yes. Thyroplasty is covered by insurance if it’s deemed to be medically necessary.

This includes thyroplasty for gender confirmation surgery ; however, your insurance company may require psychiatric evaluations or other prerequisites to determine that you’re a candidate for gender confirmation surgery.

Takeaway

Thyroplasty is a safe, effective way to improve your voice if you have vocal cord paralysis or vocal cord nodules. It’s also a tool to help change cis and transgender people change the pitch of their voice.

Talk with a doctor to make sure you understand the risks and outcomes you can expect from thyroplasty.