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Complications of type I thyroplasty and arytenoid adduction.
Laryngoscope. 2001 Aug; 111(8):1322-9.L

Abstract

OBJECTIVES/HYPOTHESIS

Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralyzed vocal fold but must be evaluated in light of potential complications following laryngeal framework surgery.

STUDY DESIGN AND METHODS

The charts of 237 patients who underwent unilateral vocal fold medialization surgery between July 1, 1991, and August 30, 1999, at a tertiary care cancer referral center were retrospectively reviewed.

RESULTS

There were 98 cases of type I thyroplasty alone and 96 cases of type I thyroplasty with arytenoid adduction. The two groups had similar patient characteristics. Mean time of surgery (45 vs. 73 min, P <.0001) and length of hospital stay (1.1 vs. 1.8 d, P <.0001) were increased when arytenoid adduction was performed. Overall improvement of symptoms was similar in both groups (93%-94%), but posterior glottic closure appeared subjectively improved when arytenoid adduction was used (P =.0054). Overall complication rates were slightly higher in the arytenoid adduction group (14% vs. 19%), primarily because of transient vocal fold edema and wound complications (9 vs. 19 cases), but the increase was not statistically significant (P =.1401). Complications warranting medical or surgical intervention occurred in 8% of cases. Two patients who underwent type I thyroplasty with arytenoid adduction required tracheotomy as a consequence of postoperative complications. The three patients who had extrusion of the implant underwent type I thyroplasty alone.

CONCLUSION

Using the appropriate technique, the potential benefits of improved glottic function following type I thyroplasty with arytenoid adduction outweigh the small risk of significant complications observed.

Authors+Show Affiliations

Department of Otolaryngology, New York University School of Medicine, New York, NY, U.S.A.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11568563

Citation

Abraham, M T., et al. "Complications of Type I Thyroplasty and Arytenoid Adduction." The Laryngoscope, vol. 111, no. 8, 2001, pp. 1322-9.
Abraham MT, Gonen M, Kraus DH. Complications of type I thyroplasty and arytenoid adduction. Laryngoscope. 2001;111(8):1322-9.
Abraham, M. T., Gonen, M., & Kraus, D. H. (2001). Complications of type I thyroplasty and arytenoid adduction. The Laryngoscope, 111(8), 1322-9.
Abraham MT, Gonen M, Kraus DH. Complications of Type I Thyroplasty and Arytenoid Adduction. Laryngoscope. 2001;111(8):1322-9. PubMed PMID: 11568563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complications of type I thyroplasty and arytenoid adduction. AU - Abraham,M T, AU - Gonen,M, AU - Kraus,D H, PY - 2001/9/25/pubmed PY - 2001/10/26/medline PY - 2001/9/25/entrez SP - 1322 EP - 9 JF - The Laryngoscope JO - Laryngoscope VL - 111 IS - 8 N2 - OBJECTIVES/HYPOTHESIS: Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralyzed vocal fold but must be evaluated in light of potential complications following laryngeal framework surgery. STUDY DESIGN AND METHODS: The charts of 237 patients who underwent unilateral vocal fold medialization surgery between July 1, 1991, and August 30, 1999, at a tertiary care cancer referral center were retrospectively reviewed. RESULTS: There were 98 cases of type I thyroplasty alone and 96 cases of type I thyroplasty with arytenoid adduction. The two groups had similar patient characteristics. Mean time of surgery (45 vs. 73 min, P <.0001) and length of hospital stay (1.1 vs. 1.8 d, P <.0001) were increased when arytenoid adduction was performed. Overall improvement of symptoms was similar in both groups (93%-94%), but posterior glottic closure appeared subjectively improved when arytenoid adduction was used (P =.0054). Overall complication rates were slightly higher in the arytenoid adduction group (14% vs. 19%), primarily because of transient vocal fold edema and wound complications (9 vs. 19 cases), but the increase was not statistically significant (P =.1401). Complications warranting medical or surgical intervention occurred in 8% of cases. Two patients who underwent type I thyroplasty with arytenoid adduction required tracheotomy as a consequence of postoperative complications. The three patients who had extrusion of the implant underwent type I thyroplasty alone. CONCLUSION: Using the appropriate technique, the potential benefits of improved glottic function following type I thyroplasty with arytenoid adduction outweigh the small risk of significant complications observed. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/11568563/Complications_of_type_I_thyroplasty_and_arytenoid_adduction_ L2 - https://doi.org/10.1097/00005537-200108000-00003 DB - PRIME DP - Unbound Medicine ER -