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Functional results after external vocal fold medialization thyroplasty with the titanium vocal fold medialization implant.
Laryngoscope. 2003 Apr; 113(4):628-34.L

Abstract

OBJECTIVES/HYPOTHESIS

A persistent insufficiency of glottal closure is mostly a consequence of a unilateral vocal fold movement impairment. It can also be caused by vocal fold atrophy or scarring processes with regular bilateral respiratory vocal fold function. Because of consequential voice, breathing, and swallowing impairments, a functional surgical treatment is required. The goal of the study was to outline the functional results after medialization thyroplasty with the titanium vocal fold medialization implant according to Friedrich.

METHODS

In the period of 1999 to 2001, an external vocal fold medialization using the titanium implant was performed on 28 patients (12 women and 16 men). The patients were in the age range of 19 to 84 years. Twenty-two patients had a paralysis of the left-side vocal fold, and six patients, of the right-side vocal fold. Detailed functional examinations were executed on all patients before and after the surgery: perceptive voice sound analysis according to the "roughness, breathiness, and hoarseness" method, judgment of the s/z ratio and voice dysfunction index, voice range profile measurements, videostroboscopy, and pulmonary function tests. In case of dysphagia/aspiration, videofluoroscopy of swallowing was also performed. The respective data were statistically analyzed (paired t test, Wilcoxon-test).

RESULTS

All patients reported on improvement of voice, swallowing, and breathing functions postoperatively. Videostroboscopy revealed an almost complete glottal closure after surgery in all of the patients. All voice-related parameters showed a significant improvement. An increase of the laryngeal resistance by the medialization procedure could be excluded by analysis of the pulmonary function test.

CONCLUSIONS

The results confirm the external medialization of the vocal folds as an adequate method in the therapy of voice, swallowing, and breathing impairment attributable to an insufficient glottal closure. The titanium implant offers, apart from good tissue tolerability, the advantage of an easy, time-saving, and individually adjustable application during the operation.

Authors+Show Affiliations

Department of Otorhinolaryngology, University Hospital of Vienna, School of Medicine, Vienna, Austria. Berit.Schneider@akh-wien.ac.atNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12671418

Citation

Schneider, Berit, et al. "Functional Results After External Vocal Fold Medialization Thyroplasty With the Titanium Vocal Fold Medialization Implant." The Laryngoscope, vol. 113, no. 4, 2003, pp. 628-34.
Schneider B, Denk DM, Bigenzahn W. Functional results after external vocal fold medialization thyroplasty with the titanium vocal fold medialization implant. Laryngoscope. 2003;113(4):628-34.
Schneider, B., Denk, D. M., & Bigenzahn, W. (2003). Functional results after external vocal fold medialization thyroplasty with the titanium vocal fold medialization implant. The Laryngoscope, 113(4), 628-34.
Schneider B, Denk DM, Bigenzahn W. Functional Results After External Vocal Fold Medialization Thyroplasty With the Titanium Vocal Fold Medialization Implant. Laryngoscope. 2003;113(4):628-34. PubMed PMID: 12671418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional results after external vocal fold medialization thyroplasty with the titanium vocal fold medialization implant. AU - Schneider,Berit, AU - Denk,Doris-Maria, AU - Bigenzahn,Wolfgang, PY - 2003/4/3/pubmed PY - 2003/5/14/medline PY - 2003/4/3/entrez SP - 628 EP - 34 JF - The Laryngoscope JO - Laryngoscope VL - 113 IS - 4 N2 - OBJECTIVES/HYPOTHESIS: A persistent insufficiency of glottal closure is mostly a consequence of a unilateral vocal fold movement impairment. It can also be caused by vocal fold atrophy or scarring processes with regular bilateral respiratory vocal fold function. Because of consequential voice, breathing, and swallowing impairments, a functional surgical treatment is required. The goal of the study was to outline the functional results after medialization thyroplasty with the titanium vocal fold medialization implant according to Friedrich. METHODS: In the period of 1999 to 2001, an external vocal fold medialization using the titanium implant was performed on 28 patients (12 women and 16 men). The patients were in the age range of 19 to 84 years. Twenty-two patients had a paralysis of the left-side vocal fold, and six patients, of the right-side vocal fold. Detailed functional examinations were executed on all patients before and after the surgery: perceptive voice sound analysis according to the "roughness, breathiness, and hoarseness" method, judgment of the s/z ratio and voice dysfunction index, voice range profile measurements, videostroboscopy, and pulmonary function tests. In case of dysphagia/aspiration, videofluoroscopy of swallowing was also performed. The respective data were statistically analyzed (paired t test, Wilcoxon-test). RESULTS: All patients reported on improvement of voice, swallowing, and breathing functions postoperatively. Videostroboscopy revealed an almost complete glottal closure after surgery in all of the patients. All voice-related parameters showed a significant improvement. An increase of the laryngeal resistance by the medialization procedure could be excluded by analysis of the pulmonary function test. CONCLUSIONS: The results confirm the external medialization of the vocal folds as an adequate method in the therapy of voice, swallowing, and breathing impairment attributable to an insufficient glottal closure. The titanium implant offers, apart from good tissue tolerability, the advantage of an easy, time-saving, and individually adjustable application during the operation. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/12671418/Functional_results_after_external_vocal_fold_medialization_thyroplasty_with_the_titanium_vocal_fold_medialization_implant_ DB - PRIME DP - Unbound Medicine ER -