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Long-term vocal outcomes of refined nerve-muscle pedicle flap implantation combined with arytenoid adduction.
Eur Arch Otorhinolaryngol. 2015 Mar; 272(3):681-8.EA

Abstract

The objective of this study is to evaluate long-term efficacy of refined nerve-muscle pedicle (NMP) flap implantation combined with arytenoid adduction (AA) for treatment of unilateral vocal fold paralysis (UVFP). The authors retrospectively reviewed 33 patients with UVFP who received refined NMP flap implantation with AA and were followed up over a 1-year period. Evaluation of vocal fold vibration (regularity, amplitude, and glottal gap), aerodynamic analysis (maximum phonation time [MPT] and mean airflow rate [MFR]), and perceptual evaluation (Grade and Breathiness) were performed preoperatively and at five different time points (1, 3, 6, 12, and 24 months) postoperatively. All voice parameters improved significantly postoperatively. All parameters except MFR also continued to improve over the course of 24 months. In the videostroboscopic analysis, the parameter for regularity 24 months after surgery was significantly improved compared with that at 1, 3, and 6 months after surgery. There were also significant improvements in amplitude and the glottal gap 24 months after surgery in comparison with values at 3 and 6 months after surgery and 3 months after surgery, respectively. Significant improvement in aerodynamic and perceptual measurements during the follow-up period together with near-normal vocal fold vibration was achieved by delayed reinnervation with refined NMP flap implantation and AA. The combined surgical technique is effective in the treatment of severe breathy dysphonia due to UVFP. Level of evidence 4.

Authors+Show Affiliations

Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, Kumamoto, 860-8556, Japan, hurukiyokizidainootoko@yahoo.co.jp.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25502739

Citation

Kodama, Narihiro, et al. "Long-term Vocal Outcomes of Refined Nerve-muscle Pedicle Flap Implantation Combined With Arytenoid Adduction." European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, vol. 272, no. 3, 2015, pp. 681-8.
Kodama N, Sanuki T, Kumai Y, et al. Long-term vocal outcomes of refined nerve-muscle pedicle flap implantation combined with arytenoid adduction. Eur Arch Otorhinolaryngol. 2015;272(3):681-8.
Kodama, N., Sanuki, T., Kumai, Y., & Yumoto, E. (2015). Long-term vocal outcomes of refined nerve-muscle pedicle flap implantation combined with arytenoid adduction. European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 272(3), 681-8. https://doi.org/10.1007/s00405-014-3418-3
Kodama N, et al. Long-term Vocal Outcomes of Refined Nerve-muscle Pedicle Flap Implantation Combined With Arytenoid Adduction. Eur Arch Otorhinolaryngol. 2015;272(3):681-8. PubMed PMID: 25502739.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term vocal outcomes of refined nerve-muscle pedicle flap implantation combined with arytenoid adduction. AU - Kodama,Narihiro, AU - Sanuki,Tetsuji, AU - Kumai,Yoshihiko, AU - Yumoto,Eiji, Y1 - 2014/12/11/ PY - 2014/10/02/received PY - 2014/11/26/accepted PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2015/8/8/medline SP - 681 EP - 8 JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JO - Eur Arch Otorhinolaryngol VL - 272 IS - 3 N2 - The objective of this study is to evaluate long-term efficacy of refined nerve-muscle pedicle (NMP) flap implantation combined with arytenoid adduction (AA) for treatment of unilateral vocal fold paralysis (UVFP). The authors retrospectively reviewed 33 patients with UVFP who received refined NMP flap implantation with AA and were followed up over a 1-year period. Evaluation of vocal fold vibration (regularity, amplitude, and glottal gap), aerodynamic analysis (maximum phonation time [MPT] and mean airflow rate [MFR]), and perceptual evaluation (Grade and Breathiness) were performed preoperatively and at five different time points (1, 3, 6, 12, and 24 months) postoperatively. All voice parameters improved significantly postoperatively. All parameters except MFR also continued to improve over the course of 24 months. In the videostroboscopic analysis, the parameter for regularity 24 months after surgery was significantly improved compared with that at 1, 3, and 6 months after surgery. There were also significant improvements in amplitude and the glottal gap 24 months after surgery in comparison with values at 3 and 6 months after surgery and 3 months after surgery, respectively. Significant improvement in aerodynamic and perceptual measurements during the follow-up period together with near-normal vocal fold vibration was achieved by delayed reinnervation with refined NMP flap implantation and AA. The combined surgical technique is effective in the treatment of severe breathy dysphonia due to UVFP. Level of evidence 4. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/25502739/Long_term_vocal_outcomes_of_refined_nerve_muscle_pedicle_flap_implantation_combined_with_arytenoid_adduction_ L2 - https://dx.doi.org/10.1007/s00405-014-3418-3 DB - PRIME DP - Unbound Medicine ER -