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Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea.
Eur Arch Otorhinolaryngol. 2017 Oct; 274(10):3703-3710.EA

Abstract

In unilateral vocal cord paralysis (UVCP), hoarseness is usually the leading symptom; however, the diminished airway might lead to breathing problems as well, especially with exertion. The application of the classic resection glottis enlarging or medialization procedures might shift the breathing and/or the voice to a worse condition. The non-destructive endoscopic arytenoid abduction lateropexy (EAAL) might be a solution for this problem. The aim of our study was to analyze the phonatory and respiratory outcomes of this treatment concept. The first year phoniatric [Jitter, Shimmer, harmonics-to-noise ratio (HNR), maximum phonation time (MPT), fundamental frequency (F 0), Voice Handicap Index (VHI), Dysphonia Severity Index (DSI), Global-Roughness-Breathiness scale (GRB)], peak inspiratory flow (PIF), and quality of life (QoL) were evaluated in ten UVCP patients treated by EAAL for dyspnea generally presented on exertion. PIF, Jitter, QoL, GRB, and VHI significantly improved. DSI, HNR, and MPT got non-significantly better. F 0 slightly increased in all patients, a mild deterioration of shimmer was observed. These results prove that improving respiratory function is not necessarily associated with a deterioration in voice quality. The EAAL provides a significant improvement in breathing and the vibratory parameters of the postoperative, more tensed and straightened vocal cords proved to be more advantageous than the original (para) median 'loose' position. The over-adduction of the contralateral side more or less compensates for the disadvantageous, more lateral position of the operated side. EAAL might be an alternative treatment for unilateral vocal cord paralysis associated with breathing problems.

Authors+Show Affiliations

Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary. bach.adam@med.u-szeged.hu.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otolaryngology, Voice and Aerodigestive Center, University of Alabama at Birmingham, Birmingham, USA.Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany.Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28791468

Citation

Matievics, Vera, et al. "Functional Outcomes of Endoscopic Arytenoid Abduction Lateropexy for Unilateral Vocal Cord Paralysis With Dyspnea." 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. 274, no. 10, 2017, pp. 3703-3710.
Matievics V, Bach A, Sztano B, et al. Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea. Eur Arch Otorhinolaryngol. 2017;274(10):3703-3710.
Matievics, V., Bach, A., Sztano, B., Bere, Z., Tobias, Z., Castellanos, P. F., Mueller, A. H., & Rovo, L. (2017). Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea. 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, 274(10), 3703-3710. https://doi.org/10.1007/s00405-017-4696-3
Matievics V, et al. Functional Outcomes of Endoscopic Arytenoid Abduction Lateropexy for Unilateral Vocal Cord Paralysis With Dyspnea. Eur Arch Otorhinolaryngol. 2017;274(10):3703-3710. PubMed PMID: 28791468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea. AU - Matievics,Vera, AU - Bach,Adam, AU - Sztano,Balazs, AU - Bere,Zsofia, AU - Tobias,Zoltan, AU - Castellanos,Paul F, AU - Mueller,Andreas H, AU - Rovo,Laszló, Y1 - 2017/08/08/ PY - 2017/05/19/received PY - 2017/07/31/accepted PY - 2017/8/10/pubmed PY - 2018/5/31/medline PY - 2017/8/10/entrez KW - Endoscopic arytenoid abduction lateropexy KW - Minimally invasive surgery KW - Respiratory function KW - Unilateral vocal cord paralysis KW - Voice quality SP - 3703 EP - 3710 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 - 274 IS - 10 N2 - In unilateral vocal cord paralysis (UVCP), hoarseness is usually the leading symptom; however, the diminished airway might lead to breathing problems as well, especially with exertion. The application of the classic resection glottis enlarging or medialization procedures might shift the breathing and/or the voice to a worse condition. The non-destructive endoscopic arytenoid abduction lateropexy (EAAL) might be a solution for this problem. The aim of our study was to analyze the phonatory and respiratory outcomes of this treatment concept. The first year phoniatric [Jitter, Shimmer, harmonics-to-noise ratio (HNR), maximum phonation time (MPT), fundamental frequency (F 0), Voice Handicap Index (VHI), Dysphonia Severity Index (DSI), Global-Roughness-Breathiness scale (GRB)], peak inspiratory flow (PIF), and quality of life (QoL) were evaluated in ten UVCP patients treated by EAAL for dyspnea generally presented on exertion. PIF, Jitter, QoL, GRB, and VHI significantly improved. DSI, HNR, and MPT got non-significantly better. F 0 slightly increased in all patients, a mild deterioration of shimmer was observed. These results prove that improving respiratory function is not necessarily associated with a deterioration in voice quality. The EAAL provides a significant improvement in breathing and the vibratory parameters of the postoperative, more tensed and straightened vocal cords proved to be more advantageous than the original (para) median 'loose' position. The over-adduction of the contralateral side more or less compensates for the disadvantageous, more lateral position of the operated side. EAAL might be an alternative treatment for unilateral vocal cord paralysis associated with breathing problems. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/28791468/Functional_outcomes_of_endoscopic_arytenoid_abduction_lateropexy_for_unilateral_vocal_cord_paralysis_with_dyspnea_ DB - PRIME DP - Unbound Medicine ER -