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Glottic closure patterns: type I thyroplasty versus type I thyroplasty with arytenoid adduction.
J Voice. 2011 May; 25(3):259-64.JV

Abstract

OBJECTIVES/HYPOTHESIS

The goal of laryngeal framework surgery in patients with unilateral vocal fold paralysis is to improve glottic closure by medializing the paralyzed vocal fold. Type I thyroplasty (Th) and arytenoid adduction (AA) are two of the most commonly performed procedures. Two of the main rationales for performing an AA are to improve closure of the posterior glottis and correct vertical height discrepancy. The purpose of this study was to evaluate if AA with Th yields better posterior glottic closure and vertical height equality than Th alone.

STUDY DESIGN

Retrospective.

METHODS

Using visual analog scales, three blinded reviewers evaluated glottic closure patterns in patients who underwent Th or Th with AA. Pre- and postoperative videostroboscopic examinations of 45 patients with unilateral vocal fold paralysis, who underwent laryngeal framework surgery, were evaluated.

RESULTS

No significant difference was identified in postoperative scores for midmembranous glottis closure (P=0.282), closure just anterior to the vocal processes (P=0.426), respiratory glottis closure (P=0.158), or vertical height discrepancy (P=0.113).

CONCLUSIONS

Although larger glottic gaps and vertical height discrepancies may lead some surgeons to predict that an AA is warranted, the usefulness of AA may not always be related to these parameters. Ultimately, voice improvement and not geometry should guide the surgeon's decision making.

Authors+Show Affiliations

Emory University School of Medicine, Atlanta, Georgia, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

20335002

Citation

Li, Anya J., et al. "Glottic Closure Patterns: Type I Thyroplasty Versus Type I Thyroplasty With Arytenoid Adduction." Journal of Voice : Official Journal of the Voice Foundation, vol. 25, no. 3, 2011, pp. 259-64.
Li AJ, Johns MM, Jackson-Menaldi C, et al. Glottic closure patterns: type I thyroplasty versus type I thyroplasty with arytenoid adduction. J Voice. 2011;25(3):259-64.
Li, A. J., Johns, M. M., Jackson-Menaldi, C., Dailey, S., Heman-Ackah, Y., Merati, A., & Rubin, A. D. (2011). Glottic closure patterns: type I thyroplasty versus type I thyroplasty with arytenoid adduction. Journal of Voice : Official Journal of the Voice Foundation, 25(3), 259-64. https://doi.org/10.1016/j.jvoice.2009.11.001
Li AJ, et al. Glottic Closure Patterns: Type I Thyroplasty Versus Type I Thyroplasty With Arytenoid Adduction. J Voice. 2011;25(3):259-64. PubMed PMID: 20335002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glottic closure patterns: type I thyroplasty versus type I thyroplasty with arytenoid adduction. AU - Li,Anya J, AU - Johns,Michael M, AU - Jackson-Menaldi,Cristina, AU - Dailey,Seth, AU - Heman-Ackah,Yolanda, AU - Merati,Albert, AU - Rubin,Adam D, Y1 - 2010/03/23/ PY - 2009/09/24/received PY - 2009/11/02/accepted PY - 2010/3/26/entrez PY - 2010/3/26/pubmed PY - 2011/8/24/medline SP - 259 EP - 64 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 25 IS - 3 N2 - OBJECTIVES/HYPOTHESIS: The goal of laryngeal framework surgery in patients with unilateral vocal fold paralysis is to improve glottic closure by medializing the paralyzed vocal fold. Type I thyroplasty (Th) and arytenoid adduction (AA) are two of the most commonly performed procedures. Two of the main rationales for performing an AA are to improve closure of the posterior glottis and correct vertical height discrepancy. The purpose of this study was to evaluate if AA with Th yields better posterior glottic closure and vertical height equality than Th alone. STUDY DESIGN: Retrospective. METHODS: Using visual analog scales, three blinded reviewers evaluated glottic closure patterns in patients who underwent Th or Th with AA. Pre- and postoperative videostroboscopic examinations of 45 patients with unilateral vocal fold paralysis, who underwent laryngeal framework surgery, were evaluated. RESULTS: No significant difference was identified in postoperative scores for midmembranous glottis closure (P=0.282), closure just anterior to the vocal processes (P=0.426), respiratory glottis closure (P=0.158), or vertical height discrepancy (P=0.113). CONCLUSIONS: Although larger glottic gaps and vertical height discrepancies may lead some surgeons to predict that an AA is warranted, the usefulness of AA may not always be related to these parameters. Ultimately, voice improvement and not geometry should guide the surgeon's decision making. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/20335002/Glottic_closure_patterns:_type_I_thyroplasty_versus_type_I_thyroplasty_with_arytenoid_adduction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(09)00206-9 DB - PRIME DP - Unbound Medicine ER -