Patient Perception of Pain With Medialization Thyroplasty Surgery

ABSTRACT Objectives Medialization thyroplasty (MT) is a procedure used to treat glottal insufficiency. It is conducted with the patient under procedural sedation for vocal feedback. The objective of this study is to evaluate the patient's perception of pain after MT surgery. Methods Prospective observational study. Patients undergoing MT completed the validated short‐form McGill Pain Questionnaire (SF‐MPQ) before surgery and post‐operative days (PODs) 1 and 7, and Voice Handicap Index‐10 questionnaire (VHI‐10) before surgery and POD7. Demographic and clinical data were collected. Nonparametric tests were conducted for statistical analysis. Results Fifty‐three patients (47% male), with a median age of 67 years (IQR 15) were recruited between March 2023 and February 2025. On POD1, 74% required analgesia and 52% required opioids. Pre‐operative SF‐MPQ was median 0 (IQR 0), which increased significantly on POD1 to 3.0 (IQR 7.5) ( p < 0.0001) and decreased significantly on POD7 to median 1.0 (IQR 3.0) ( p < 0.0001). Voices significantly improved, from pre‐operative VHI‐10 score of 26 (IQR 14) to POD7 score of 12 (IQR 13) ( p < 0.0001). None of the following factors were associated with increased pain: age, sex, BMI, anxiety diagnosis, per‐operative, regular intake of pain medication, surgical time or pre‐operative VHI score. Conclusions Although MT was completed under procedural sedation, pain was well tolerated after surgery. Half of the patients used opioids for post‐operative pain, and the levels of pain were mild. There are opportunities for improved opioid stewardship in the pain management of this surgery. This study is one of the few prospective studies evaluating pain with MT. Level of Evidence 4.