Silastic vs. Gore-Tex for Type 1 Thyroplasty: A Systematic Review of Outcomes
Type 1 thyroplasty has long been used to restore a patient’s voice in cases of vocal cord paralysis. In the procedure, an implant is used to push the paralyzed vocal cord closer to the working vocal cord to produce sound. In research done in the Department of Otorhinolaryngology at McGovern Medical School at UTHealth Houston, investigators conducted a systematic review to compare the efficacy of two synthetic materials commonly used as implants – Silastic™ and Gore-Tex®.
“A paralyzed vocal cord sits immobilized off to the side of the voice box, lacking the ability to move to the middle to meet the other vocal cord and produce sound. If one vocal cord is functioning, we can use a custom-sized synthetic implant to push the nonworking cord toward it, allowing the larynx to function properly,” says Andrew Tritter, MD, director of the Texas Voice Performance Institute™ and an assistant professor in the department. “Our goal with the study was to examine all the data available across all published studies to determine if Silastic is better than Gore-Tex.”
A systematic review and meta-analysis using multiple online databases yielded 960 records, with 100 manuscripts ultimately included in the study. “We found that both implants provide adequate and comparable results in Type 1 thyroplasty, but the data used to support this conclusion are based on inconsistent metrics,” Dr. Tritter says. “This is clearly a question no one has tried to answer in a well-randomized environment. In the cases we treated over a few months in our department, we found Gore-Tex technically a bit easier to work with, but future research using standardized metrics is needed to determine which implant is better.”
The research was presented by Amy Lemming, MD, and Dylan Vance, MD, fourth-year residents in the department, and by David Allen, MD, a chief resident, at the national American Laryngological Association meeting in Chicago 2024.