First Flemish patient receives adjustable vocal cord implant

Hoarseness caused by vocal cord paralysis

Damage to a vocal cord nerve can cause one of the vocal cords to stop working, preventing the vocal cords from closing properly. This can cause hoarseness and swallowing or breathing problems. The nerve can be damaged by surgery in the chest cavity or neck, but sometimes the cause of the vocal cord problems is unknown.

To restore the voice, the paralysed vocal cord is moved closer to the centre so that the vocal cords make contact again when speaking. This can be done in various ways.

• One option is an injection into the immobile vocal cord, which thickens it and allows the vocal cords to close more effectively when speaking. This is a simple procedure, but the effect is temporary.
• A second option is laryngeal reinnervation, an operation in which the damaged or non-functioning vocal cord nerve in the throat is connected to a nerve that is still functioning, so that the paralysed vocal cord receives nerve impulses again. This technique is only used in people under the age of 70. This is because nerve repair is more successful at a younger age and in patients who have not yet undergone radiation therapy to the head and neck area.
• Since a large proportion of people with vocal cord paralysis are over 70 years of age, an implant placed in the larynx is an excellent third option. The preformed silicone implants used to date usually produce good results. However, the disadvantage of this option is that the implant cannot be adjusted afterwards. If the vocal cord weakens and thins further over time, a new operation may be necessary to insert a larger implant.

Adjustable balloon

Doctors at UZ Leuven are therefore now using a new type of implant. Thanks to a special balloon, the implant, called “APrevent® VOIS”, can be easily adjusted if the voice changes afterwards, for example because the vocal cord muscle becomes thinner.