Material for vocal cord medialization, synthetic (implantable)
HCPCS code
Name of the Procedure:
Vocal Cord Medialization - Synthetic Implant (HCPCS C1878)
Summary
Vocal cord medialization using a synthetic implant is a surgical procedure to reposition and support one or both vocal cords. This can improve voice quality and address issues with swallowing and breathing caused by vocal cord paralysis or atrophy.
Purpose
The procedure aims to improve voice strength and quality, enhance swallowing, and assist in protecting the airway by properly positioning the vocal cords.
Indications
- Vocal cord paralysis or paresis
- Atrophied (thin or weak) vocal cords
- Hoarseness or weak voice
- Aspiration risk or difficulty swallowing
Preparation
- Patients may need to fast for several hours before the procedure.
- Adjustments to medications, such as blood thinners, might be necessary.
- Pre-operative assessment, including laryngoscopy, may be done to evaluate vocal cord function.
Procedure Description
- The patient receives local anesthesia with sedation or general anesthesia.
- A small incision is made in the neck.
- Using specialized instruments, the surgeon places a synthetic implant (HCPCS C1878) into the vocal cord area.
- The implant helps to move the vocal cord toward the midline, improving its function.
- The incision is closed, and a bandage may be applied.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
The procedure is usually performed in a hospital operating room or a surgical center.
Personnel
- ENT Surgeon (Otolaryngologist)
- Anesthesiologist
- Surgical Nurses
- Operating Room Technicians
Risks and Complications
- Infection
- Implant displacement or extrusion
- Changes in voice quality
- Airway obstruction
- Bleeding or hematoma
- Scarring
Benefits
- Improved voice quality and volume
- Enhanced swallowing function
- Reduced risk of aspiration
- Increased confidence and quality of life Benefits are often realized within a few weeks post-surgery.
Recovery
- Pain management with prescribed medications
- Resting the voice and avoiding heavy lifting
- Follow-up appointments to monitor healing
- Most patients can return to normal activities within 1 to 2 weeks, but voice rest may be recommended for longer.
Alternatives
- Voice therapy
- Injection laryngoplasty (temporary filler injection)
- Medialization thyroplasty (using different materials)
- Each alternative has its own risks, benefits, and duration of effectiveness compared to a synthetic implant.
Patient Experience
During the procedure, patients under local anesthesia with sedation might feel mild pressure but no pain. General anesthesia ensures they are completely asleep. Post-procedure, mild to moderate throat discomfort and swelling are common but managed with medication. Patients usually report noticeable voice improvement within weeks.
Pain management and comfort measures, including medication, throat lozenges, and voice rest, are used to ensure a smooth recovery.