A standardized system has been developed to treat unilateral vocal cord paralysis by medialization of the paralyzed cord. The Montgomery Thyroplasty Implant System consists of a medialization implant, measuring devices, and surgical instruments. The surgical instruments are used to locate, measure, and create a window in the thyroid lamina in which the implant is placed. The measuring devices are used to predetermine the correct implant size. There are five sizes for males (8 to 12 mm) and five for females (6 to 10 mm), with the size representing the distance of medialization. The implant consists of a firm, three-tiered base that locks the implant in the cartilage, and a soft, triangular top that serves to medialize the cord. The standardization of the base allows for revision or reversal at a later date without disturbing the window. The thyroplasty system and surgical procedures are described. Preliminary results of 176 patients who have undergone the Montgomery Thyroplasty Implant System procedure are presented.