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We sought to compare outcomes between Silastic and Gore\u2010Tex implants via systematic review and meta\u2010analysis for unilateral vocal fold immobility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected available data from PubMed, Embase, and Web of Science on demographics, maximum phonation time (MPT), voice handicap index (VHI\u201010\/30) score, and any other relevant metrics encountered before comparatively evaluating differences in outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u2010Tex for a total of 245 patients. The pooled mean increase in MPT for Silastic patients was 7.8\u2009s (+1.3 SMD) compared with 5.7\u2009s for Gore\u2010Tex (+1.6 SMD). There was significant publication bias present in both analyses. The pooled mean change in VHI\u201030 with Silastic was \u221245.4 (62.2%, \u22122.09 SMD) compared with \u221251.6 (73.5%, \u22121.1 SMD) with Gore\u2010Tex. The pooled mean change in VHI\u201010 with Silastic was \u221215.6 (54%, \u22120.46 SMD) compared with \u221211.6 (43%, \u22120.86 SMD) with Gore\u2010Tex. There was no significant publication bias present in VHI outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Silicone and Gore\u2010Tex implants provide adequate and comparable results in TT1. The data supporting this conclusion are limited by follow\u2010up, diversity in outcomes, limited data availability, and publication bias. Future research should be dedicated to comparing implants in a well\u2010randomized environment. <jats:italic>Laryngoscope<\/jats:italic>, 135:1236\u20131247, 2025<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31867","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T13:44:15Z","timestamp":1730900655000},"page":"1236-1247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Systematic Review and Meta\u2010Analysis of Outcomes in Type 1 Thyroplasty Comparing Silastic to Gore\u2010Tex"],"prefix":"10.1002","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-8510","authenticated-orcid":false,"given":"Dylan G.","family":"Vance","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery UT Health Houston \u2013 McGovern Medical School  Houston Texas 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