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Meta-Analysis
. 2025 Apr;135(4):1236-1247.
doi: 10.1002/lary.31867. Epub 2024 Nov 6.

Systematic Review and Meta-Analysis of Outcomes in Type 1 Thyroplasty Comparing Silastic to Gore-Tex

Dylan G Vance  1 , David Z Allen  1 , Amy B Leming  1 , Madisyn Cox  2 , Sonya E Fogg  3 , Sameer H Siddiqui  2 , Hallie R Wilson  2 , Andrew G Tritter  1
Affiliations
Meta-Analysis

Systematic Review and Meta-Analysis of Outcomes in Type 1 Thyroplasty Comparing Silastic to Gore-Tex

Dylan G Vance et al. Laryngoscope. 2025 Apr.

Abstract

Objective: Type 1 Thyroplasty is a well-established procedure used for medializing an immobile vocal fold. Silastic and Gore-Tex are the two most common materials used to accomplish this, but comparative data on their relative efficacy are scarce. We sought to compare outcomes between Silastic and Gore-Tex implants via systematic review and meta-analysis for unilateral vocal fold immobility.

Methods: We collected available data from PubMed, Embase, and Web of Science on demographics, maximum phonation time (MPT), voice handicap index (VHI-10/30) score, and any other relevant metrics encountered before comparatively evaluating differences in outcomes.

Results: The search yielded 1,534 records with 55 manuscripts ultimately included. There were 41 unique studies that utilized Silastic for a total of 1038 patients. There were 13 unique studies that utilized Gore-Tex for a total of 245 patients. The pooled mean increase in MPT for Silastic patients was 7.8 s (+1.3 SMD) compared with 5.7 s for Gore-Tex (+1.6 SMD). There was significant publication bias present in both analyses. The pooled mean change in VHI-30 with Silastic was -45.4 (62.2%, -2.09 SMD) compared with -51.6 (73.5%, -1.1 SMD) with Gore-Tex. The pooled mean change in VHI-10 with Silastic was -15.6 (54%, -0.46 SMD) compared with -11.6 (43%, -0.86 SMD) with Gore-Tex. There was no significant publication bias present in VHI outcomes.

Conclusions: Silicone and Gore-Tex implants provide adequate and comparable results in TT1. The data supporting this conclusion are limited by follow-up, diversity in outcomes, limited data availability, and publication bias. Future research should be dedicated to comparing implants in a well-randomized environment. Laryngoscope, 135:1236-1247, 2025.

Keywords: Gore‐Tex; Silastic; Thyroplasty; glottic insufficiency; medialization laryngoplasty; meta‐analysis; systematic review; vocal fold medialization.

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References

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