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Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis.
J Voice. 2018 Sep; 32(5):625-632.JV

Abstract

OBJECTIVES

Patients with unilateral vocal fold paralysis (UVFP) caused by nerve injury manifest with voice changes. This study investigated vocal performance measured by voice range profile (VRP) in patients with UVFP and changes in VRP in response to intracordal hyaluronate injection.

METHODS

Eighty-five patients with UVFP were enrolled prospectively, among whom 68 received intracordal hyaluronate injections. The outcome measurements included VRP, acoustic and aerodynamic analyses, peak turn frequency of thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) measured by laryngeal electromyography, and normalized glottal gap area by videolaryngostroboscopy.

RESULTS

The peak turn frequency of the paralyzed TA-LCA showed a modest correlation with max fundamental frequency (F0) and F0 range. Closed-phase normalized glottal gap area showed modest negative correlations with max F0 and F0 semitone range. Regarding conventional acoustic and aerodynamic analyses, the paralyzed TA-LCA peak turn frequency was only correlated with maximal phonation time. Intracordal hyaluronate injection improved VRP performance by increasing max F0, decreasing min F0, increasing F0 range, and increasing semitone range (all P <0.01) with small or medium strength of effect size (Cohen d, 0.39-0.76).

CONCLUSIONS

Change in voice pitch in patients with UVFP can partly predict impairment of neuromuscular functions and glottal gap. VRP provides a more sensitive reflection of the severity of neuromuscular impairment, compared with conventional voice analysis. The validity of VRP is further supported by a robust response to voice improvements following injection laryngoplasty.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Graduate School of Management, Ming Chung University, Taipei, Taiwan.School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. Electronic address: fang3109@cgmh.org.tw.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29248388

Citation

Pei, Yu-Cheng, et al. "Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis." Journal of Voice : Official Journal of the Voice Foundation, vol. 32, no. 5, 2018, pp. 625-632.
Pei YC, Chuang HF, Chang CF, et al. Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis. J Voice. 2018;32(5):625-632.
Pei, Y. C., Chuang, H. F., Chang, C. F., Chang, T. L., Chiang, H. C., & Fang, T. J. (2018). Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis. Journal of Voice : Official Journal of the Voice Foundation, 32(5), 625-632. https://doi.org/10.1016/j.jvoice.2017.07.019
Pei YC, et al. Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis. J Voice. 2018;32(5):625-632. PubMed PMID: 29248388.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis. AU - Pei,Yu-Cheng, AU - Chuang,Hsiu-Feng, AU - Chang,Chia-Fen, AU - Chang,Tzu-Ling, AU - Chiang,Hui-Chen, AU - Fang,Tuan-Jen, Y1 - 2017/12/13/ PY - 2017/05/29/received PY - 2017/07/23/revised PY - 2017/07/25/accepted PY - 2017/12/19/pubmed PY - 2018/12/12/medline PY - 2017/12/18/entrez KW - Hyaluronate injection laryngoplasty KW - Laryngeal electromyography KW - Phonetogram KW - Unilateral vocal fold paralysis KW - Voice range profile SP - 625 EP - 632 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 32 IS - 5 N2 - OBJECTIVES: Patients with unilateral vocal fold paralysis (UVFP) caused by nerve injury manifest with voice changes. This study investigated vocal performance measured by voice range profile (VRP) in patients with UVFP and changes in VRP in response to intracordal hyaluronate injection. METHODS: Eighty-five patients with UVFP were enrolled prospectively, among whom 68 received intracordal hyaluronate injections. The outcome measurements included VRP, acoustic and aerodynamic analyses, peak turn frequency of thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) measured by laryngeal electromyography, and normalized glottal gap area by videolaryngostroboscopy. RESULTS: The peak turn frequency of the paralyzed TA-LCA showed a modest correlation with max fundamental frequency (F0) and F0 range. Closed-phase normalized glottal gap area showed modest negative correlations with max F0 and F0 semitone range. Regarding conventional acoustic and aerodynamic analyses, the paralyzed TA-LCA peak turn frequency was only correlated with maximal phonation time. Intracordal hyaluronate injection improved VRP performance by increasing max F0, decreasing min F0, increasing F0 range, and increasing semitone range (all P <0.01) with small or medium strength of effect size (Cohen d, 0.39-0.76). CONCLUSIONS: Change in voice pitch in patients with UVFP can partly predict impairment of neuromuscular functions and glottal gap. VRP provides a more sensitive reflection of the severity of neuromuscular impairment, compared with conventional voice analysis. The validity of VRP is further supported by a robust response to voice improvements following injection laryngoplasty. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/29248388/Voice_Range_Change_After_Injection_Laryngoplasty_for_Unilateral_Vocal_Fold_Paralysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(17)30232-1 DB - PRIME DP - Unbound Medicine ER -