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Outcomes of medialization laryngoplasty with and without arytenoid adduction.
Laryngoscope. 2017 11; 127(11):2591-2595.L

Abstract

OBJECTIVES/HYPOTHESIS

To evaluate the effect of medialization laryngoplasty (ML) performed alone compared to ML with arytenoid adduction (AA) on glottic gap and voice quality in unilateral vocal fold paralysis (UVFP) patients.

STUDY DESIGN

Retrospective case series.

METHODS

UVFP patients treated with ML alone and ML with AA at the University of California San Francisco Voice and Swallowing Center were identified. Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative examinations were digitally analyzed using ImageJ for normalized anterior and posterior glottic gap and voice samples graded with CAPE-V scores.

RESULTS

Forty-seven patients underwent ML and 27 patients underwent ML with AA. Normalized anterior gap (AG) improved in both ML (preop: 4.4 pixel units (u), postop: 0.8 u; P < 0.001) and ML with AA groups (preop: 3.3 u, postop 0.6 u; P < 0.001). There was no statistically significant difference in normalized AG values between treatment groups. Postoperative normalized posterior gap (PG) improved in the ML with AA group only (preop: 1.8 u, postop: 0.5 u; P = 0.01). Overall severity, roughness, and strain voice parameters had acceptable reliability for analysis. Overall severity improved in ML (preop: 54, postop: 27; P < 0.001) and ML with AA (preop: 44, postop: 24; P = 0.005). There was no statistically significant difference in any voice parameter between treatment groups.

CONCLUSION

UVFP patients undergoing ML may benefit from addition of AA when a large posterior glottic gap is present. In this study, ML with AA but not ML alone resulted in statistically significant improvement in PG.

LEVEL OF EVIDENCE

4. Laryngoscope, 127:2591-2595, 2017.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, U.S.A.Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28699172

Citation

Chang, Joseph, et al. "Outcomes of Medialization Laryngoplasty With and Without Arytenoid Adduction." The Laryngoscope, vol. 127, no. 11, 2017, pp. 2591-2595.
Chang J, Schneider SL, Curtis J, et al. Outcomes of medialization laryngoplasty with and without arytenoid adduction. Laryngoscope. 2017;127(11):2591-2595.
Chang, J., Schneider, S. L., Curtis, J., Langenstein, J., Courey, M. S., & Yung, K. C. (2017). Outcomes of medialization laryngoplasty with and without arytenoid adduction. The Laryngoscope, 127(11), 2591-2595. https://doi.org/10.1002/lary.26773
Chang J, et al. Outcomes of Medialization Laryngoplasty With and Without Arytenoid Adduction. Laryngoscope. 2017;127(11):2591-2595. PubMed PMID: 28699172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of medialization laryngoplasty with and without arytenoid adduction. AU - Chang,Joseph, AU - Schneider,Sarah L, AU - Curtis,James, AU - Langenstein,Jonelyn, AU - Courey,Mark S, AU - Yung,Katherine C, Y1 - 2017/07/12/ PY - 2017/03/16/received PY - 2017/05/16/revised PY - 2017/06/06/accepted PY - 2017/7/13/pubmed PY - 2017/10/31/medline PY - 2017/7/13/entrez KW - Laryngoplasty KW - arytenoid adduction KW - glottic gap KW - permanent medialization laryngoplasty KW - type I thyroplasty KW - unilateral vocal fold paralysis SP - 2591 EP - 2595 JF - The Laryngoscope JO - Laryngoscope VL - 127 IS - 11 N2 - OBJECTIVES/HYPOTHESIS: To evaluate the effect of medialization laryngoplasty (ML) performed alone compared to ML with arytenoid adduction (AA) on glottic gap and voice quality in unilateral vocal fold paralysis (UVFP) patients. STUDY DESIGN: Retrospective case series. METHODS: UVFP patients treated with ML alone and ML with AA at the University of California San Francisco Voice and Swallowing Center were identified. Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative examinations were digitally analyzed using ImageJ for normalized anterior and posterior glottic gap and voice samples graded with CAPE-V scores. RESULTS: Forty-seven patients underwent ML and 27 patients underwent ML with AA. Normalized anterior gap (AG) improved in both ML (preop: 4.4 pixel units (u), postop: 0.8 u; P < 0.001) and ML with AA groups (preop: 3.3 u, postop 0.6 u; P < 0.001). There was no statistically significant difference in normalized AG values between treatment groups. Postoperative normalized posterior gap (PG) improved in the ML with AA group only (preop: 1.8 u, postop: 0.5 u; P = 0.01). Overall severity, roughness, and strain voice parameters had acceptable reliability for analysis. Overall severity improved in ML (preop: 54, postop: 27; P < 0.001) and ML with AA (preop: 44, postop: 24; P = 0.005). There was no statistically significant difference in any voice parameter between treatment groups. CONCLUSION: UVFP patients undergoing ML may benefit from addition of AA when a large posterior glottic gap is present. In this study, ML with AA but not ML alone resulted in statistically significant improvement in PG. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2591-2595, 2017. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/28699172/Outcomes_of_medialization_laryngoplasty_with_and_without_arytenoid_adduction_ L2 - https://doi.org/10.1002/lary.26773 DB - PRIME DP - Unbound Medicine ER -