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[Montgomery thyroplasty implant under local anesthesia for unilateral laryngeal paralysis].
Ann Otolaryngol Chir Cervicofac. 2003 Nov; 120(5):259-67.AO

Abstract

OBJECTIVES

Based on an inception cohort of 63 patients with unilateral vocal fold paralysis consecutively treated with thyroplasty and Montgomery's implant under local anesthesia during the years 1997-2002, we recorded i) morbidity and mortality, ii) evolution of dysphonia and swallowing impairment and iii) a prospective analysis of selected speech and voice parameters in an attempt to determine their evolution during the first 12 postoperative months and to search for potential statistical relationships with the following variables (age, gender, side of the paralysis, etiology of the paralysis, time between onset of paralysis and thyroplasty, position of the paralyzed true vocal fold, nerve involved, associated pneumonectomy, prior intracordal injection of autologous fat and surgeon).

RESULTS

The overall complication rate was 8%. Minor complications occurred in 6.5% of the patients and included 4 cases of laryngeal edema successfully treated with oral steroids. Major complications occurred in 1.5% of the patients. Intralaryngeal hematoma requiring temporary tracheotomy was the major complication. Swallowing was improved in 93.5% of the patients. Immediate improvement of speech and voice was noted in all. Secondary degradation of speech and voice occurred in one patient. At revision thyroplasty lateral displacement of the implant was noted and successfully repositioned. At one month post-operatively, the values of maximum phonation time, speech rate, group phrasing standard deviation of the fundamental frequency, jitter and shimmer were statistically improved while the fundamental frequency did not vary significantly. At 12 months post-operatively the noise to harmonic ratio was improved while the other parameters remained stable. No significant statistical relationship was found between the post-operative speech and voice parameters and the variables under analysis.

CONCLUSION

Based on the current series and a review of the medical literature, thyroplasty with Montgomery's implant under local anesthesia appears to be an easy, effective and safe procedure that might be used in all patients with unilateral laryngeal nerve paralysis.

Authors+Show Affiliations

Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital européen Georges Pompidou, assistance publique des hôpitaux de Paris, université Paris V, 20-40 rue Leblanc, 75015, Paris.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

14726844

Citation

Michel, F, et al. "[Montgomery Thyroplasty Implant Under Local Anesthesia for Unilateral Laryngeal Paralysis]." Annales D'oto-laryngologie Et De Chirurgie Cervico Faciale : Bulletin De La Societe D'oto-laryngologie Des Hopitaux De Paris, vol. 120, no. 5, 2003, pp. 259-67.
Michel F, Hans S, Crevier-Buchman L, et al. [Montgomery thyroplasty implant under local anesthesia for unilateral laryngeal paralysis]. Ann Otolaryngol Chir Cervicofac. 2003;120(5):259-67.
Michel, F., Hans, S., Crevier-Buchman, L., Brasnu, D., Menard, M., & Laccourreye, O. (2003). [Montgomery thyroplasty implant under local anesthesia for unilateral laryngeal paralysis]. Annales D'oto-laryngologie Et De Chirurgie Cervico Faciale : Bulletin De La Societe D'oto-laryngologie Des Hopitaux De Paris, 120(5), 259-67.
Michel F, et al. [Montgomery Thyroplasty Implant Under Local Anesthesia for Unilateral Laryngeal Paralysis]. Ann Otolaryngol Chir Cervicofac. 2003;120(5):259-67. PubMed PMID: 14726844.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Montgomery thyroplasty implant under local anesthesia for unilateral laryngeal paralysis]. AU - Michel,F, AU - Hans,S, AU - Crevier-Buchman,L, AU - Brasnu,D, AU - Menard,M, AU - Laccourreye,O, PY - 2004/1/17/pubmed PY - 2004/3/3/medline PY - 2004/1/17/entrez SP - 259 EP - 67 JF - Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris JO - Ann Otolaryngol Chir Cervicofac VL - 120 IS - 5 N2 - OBJECTIVES: Based on an inception cohort of 63 patients with unilateral vocal fold paralysis consecutively treated with thyroplasty and Montgomery's implant under local anesthesia during the years 1997-2002, we recorded i) morbidity and mortality, ii) evolution of dysphonia and swallowing impairment and iii) a prospective analysis of selected speech and voice parameters in an attempt to determine their evolution during the first 12 postoperative months and to search for potential statistical relationships with the following variables (age, gender, side of the paralysis, etiology of the paralysis, time between onset of paralysis and thyroplasty, position of the paralyzed true vocal fold, nerve involved, associated pneumonectomy, prior intracordal injection of autologous fat and surgeon). RESULTS: The overall complication rate was 8%. Minor complications occurred in 6.5% of the patients and included 4 cases of laryngeal edema successfully treated with oral steroids. Major complications occurred in 1.5% of the patients. Intralaryngeal hematoma requiring temporary tracheotomy was the major complication. Swallowing was improved in 93.5% of the patients. Immediate improvement of speech and voice was noted in all. Secondary degradation of speech and voice occurred in one patient. At revision thyroplasty lateral displacement of the implant was noted and successfully repositioned. At one month post-operatively, the values of maximum phonation time, speech rate, group phrasing standard deviation of the fundamental frequency, jitter and shimmer were statistically improved while the fundamental frequency did not vary significantly. At 12 months post-operatively the noise to harmonic ratio was improved while the other parameters remained stable. No significant statistical relationship was found between the post-operative speech and voice parameters and the variables under analysis. CONCLUSION: Based on the current series and a review of the medical literature, thyroplasty with Montgomery's implant under local anesthesia appears to be an easy, effective and safe procedure that might be used in all patients with unilateral laryngeal nerve paralysis. SN - 0003-438X UR - https://www.unboundmedicine.com/medline/citation/14726844/[Montgomery_thyroplasty_implant_under_local_anesthesia_for_unilateral_laryngeal_paralysis]_ L2 - http://www.em-consulte.com/retrieve/pii/MDOI-AORL-11-2003-120-5-0003-438X-101019-ART1 DB - PRIME DP - Unbound Medicine ER -