Medialization

Medialization is the act or process of moving a structure toward the midline of the body. In clinical practice, it often refers to procedures or implants designed to reposition tissues medially to improve function, symmetry, or protection of the airway.

In otolaryngology, medialization of the vocal fold is a common approach to treating glottic insufficiency, typically due to unilateral vocal cord paralysis or paresis. The goal is to reduce the gap between the vocal folds during phonation and swallowing, improving voice quality and reducing risk of aspiration. There are two principal methods: injection laryngoplasty and medialization thyroplasty (type I). Injection laryngoplasty involves injecting biocompatible material into the paralyzed vocal fold to bulk it and push it toward the midline. Materials include hyaluronic acid, calcium hydroxylapatite, collagen, fat, or other approved injectables; some are temporary while others offer longer duration. Medialization thyroplasty places a solid implant through a window in the thyroid cartilage to push the vocal fold medially and achieve durable medialization. This approach may require general anesthesia and meticulous patient selection.

Other uses of the term occur in medicine and imaging to describe any procedure or effect that shifts a structure closer to the midline. In practice, the choice between medialization methods depends on factors such as the cause and duration of dysfunction, desired durability, and patient preference.