Management of vocal fold paralysis and paresis continues to give rise to controversy and the use of numerous surgical techniques. The senior authors' (RTS, JRS) initial experience with fourteen patients using Gore-Tex Medialization Thyroplasty suggests that this technique has value. Evaluation included pre- and postoperative videostroboscopic assessment, aerodynamic measures, acoustic analysis, phonatory analysis, psychoacoustic evaluation, and patient self-evaluation. Stroboscopic and perceptual assessments were blinded. Statistical analysis supports the efficacy of this technique.