MINORS Criteria

Background: Type 1 thyroplasty, first described by Isshiki et al., is a standard surgical intervention that medializes the paralyzed vocal fold using various implant materials to restore phonation.Objectives: This scoping review aimed to compare pre- and postoperative subjective (VHI-10/30) and objective (MPT and MDVP) phonation outcomes across different implant materials, and to identify the optimal material for Type 1 thyroplasty.Methods: A scoping search of PubMed and Scopus was conducted for studies published between 2014 and 2024. This study use PRISMA-Scr: Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guideline. Studies reporting pre- and postoperative phonation outcomes in UVFP patients undergoing Type 1 thyroplasty with specified implant materials were included. Weighted means were calculated to compare outcomes across implant types.Results: From 227 screened articles, 164 patients were included. Five implant materials were identified: titanium (n=27), Gore-Tex (n=94), silicone/silastic (n=25), and cadaveric fascia lata (n=10). Titanium implants demonstrated the greatest improvements in MPT (17.6 seconds) and VHI-30 (53.31 points). Gore-Tex and silicone/silastic showed moderate gains, while cadaveric fascia lata yielded the least MPT improvement and intermediate VHI-30 scores, with increased noise-to-harmonics ratios due to graft resorption. MDVP analysis indicated stable or improved acoustic parameters with synthetic implants. Complication rates were low.Conclusion: Titanium implants provided the most durable voice improvements, though current evidence is limited by small cohorts and combined procedures. Synthetic materials offer intermediate efficacy, while biological grafts are less effective but remain alternatives when synthetics are unavailable. Personalized implant selection and future prospective trials with standardized outcome measures are needed to guide optimal material choice in Type 1 thyroplasty.Clinical Significance: This review demonstrates that the choice of implant material in type 1 thyroplasty has a substantial impact on both subjective and objective voice outcomes for patients with unilateral vocal fold paralysis. These findings highlight the importance of individualized implant selection to optimize long-term phonatory outcomes and improve quality of life in affected patients.Registration: This scoping review was registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/WZNEK)