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Treatment Outcomes of Bilateral Medialization Thyroplasty for Presbylaryngis.
J Voice. 2019 Jan; 33(1):40-44.JV

Abstract

BACKGROUND

Presbylaryngis is a common cause of dysphonia in elderly patients. Type I thyroplasty serves to improve glottic closure and vocal quality by correcting bowing. Although unilateral and injection-based procedures are well-characterized in the treatment of broadly defined glottic insufficiency, there are insufficient outcomes data for bilateral medialization thyroplasty in the treatment of presbylaryngis. The aim of this study was to review the change in measures of vocal quality before and after bilateral medialization thyroplasty for presbylaryngis.

STUDY DESIGN

This is a retrospective case series.

METHODS

The records of 21 patients with presbylaryngis undergoing bilateral medialization thyroplasty between 2007 and 2014 were reviewed. Implant materials included silastic (n = 17) and hydroxyapatite (n = 4). Preoperative and postoperative comparison of vocal function was conducted using Voice Handicap Index, maximum phonation time, auditory-perceptual severity ratings, and blinded paired-comparison of Consensus Auditory-Perceptual Evaluation of Voice and Visual-perceptual stroboscopic ratings. Paired sample t tests were used to assess all outcome measures.

RESULTS

Significant improvements were found in Voice Handicap Index scores (P < 0.007), maximum phonation time (P < 0.03), Consensus Auditory-Perceptual Evaluation of Voice (P < 0.04), and clinician rating of vocal quality (P < 0.0001). Blinded raters noted a significant improvement in audio (P < 0.05) and videostroboscopic (P < 0.003) samples after surgery. There were no operative complications observed, and median hospital stay was one night.

CONCLUSIONS

Patients with presbylaryngis demonstrated significant improvement in both objective and subjective measures of vocal quality following bilateral medialization thyroplasty. These data suggest that medialization thyroplasty is a safe option that warrants consideration in the treatment of presbylaryngis.

Authors+Show Affiliations

Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina. Electronic address: allenswo@musc.edu.Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon.Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon.Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon.Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29326026

Citation

Allensworth, Jordan J., et al. "Treatment Outcomes of Bilateral Medialization Thyroplasty for Presbylaryngis." Journal of Voice : Official Journal of the Voice Foundation, vol. 33, no. 1, 2019, pp. 40-44.
Allensworth JJ, O'Dell K, Ziegler A, et al. Treatment Outcomes of Bilateral Medialization Thyroplasty for Presbylaryngis. J Voice. 2019;33(1):40-44.
Allensworth, J. J., O'Dell, K., Ziegler, A., Bryans, L., Flint, P., & Schindler, J. (2019). Treatment Outcomes of Bilateral Medialization Thyroplasty for Presbylaryngis. Journal of Voice : Official Journal of the Voice Foundation, 33(1), 40-44. https://doi.org/10.1016/j.jvoice.2017.10.014
Allensworth JJ, et al. Treatment Outcomes of Bilateral Medialization Thyroplasty for Presbylaryngis. J Voice. 2019;33(1):40-44. PubMed PMID: 29326026.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment Outcomes of Bilateral Medialization Thyroplasty for Presbylaryngis. AU - Allensworth,Jordan J, AU - O'Dell,Karla, AU - Ziegler,Aaron, AU - Bryans,Linda, AU - Flint,Paul, AU - Schindler,Joshua, Y1 - 2018/01/08/ PY - 2017/07/26/received PY - 2017/10/17/revised PY - 2017/10/18/accepted PY - 2018/1/13/pubmed PY - 2019/6/4/medline PY - 2018/1/13/entrez KW - Atrophy KW - Bilateral KW - Medialization KW - Presbylaryngis KW - Thyroplasty SP - 40 EP - 44 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 33 IS - 1 N2 - BACKGROUND: Presbylaryngis is a common cause of dysphonia in elderly patients. Type I thyroplasty serves to improve glottic closure and vocal quality by correcting bowing. Although unilateral and injection-based procedures are well-characterized in the treatment of broadly defined glottic insufficiency, there are insufficient outcomes data for bilateral medialization thyroplasty in the treatment of presbylaryngis. The aim of this study was to review the change in measures of vocal quality before and after bilateral medialization thyroplasty for presbylaryngis. STUDY DESIGN: This is a retrospective case series. METHODS: The records of 21 patients with presbylaryngis undergoing bilateral medialization thyroplasty between 2007 and 2014 were reviewed. Implant materials included silastic (n = 17) and hydroxyapatite (n = 4). Preoperative and postoperative comparison of vocal function was conducted using Voice Handicap Index, maximum phonation time, auditory-perceptual severity ratings, and blinded paired-comparison of Consensus Auditory-Perceptual Evaluation of Voice and Visual-perceptual stroboscopic ratings. Paired sample t tests were used to assess all outcome measures. RESULTS: Significant improvements were found in Voice Handicap Index scores (P < 0.007), maximum phonation time (P < 0.03), Consensus Auditory-Perceptual Evaluation of Voice (P < 0.04), and clinician rating of vocal quality (P < 0.0001). Blinded raters noted a significant improvement in audio (P < 0.05) and videostroboscopic (P < 0.003) samples after surgery. There were no operative complications observed, and median hospital stay was one night. CONCLUSIONS: Patients with presbylaryngis demonstrated significant improvement in both objective and subjective measures of vocal quality following bilateral medialization thyroplasty. These data suggest that medialization thyroplasty is a safe option that warrants consideration in the treatment of presbylaryngis. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/29326026/Treatment_Outcomes_of_Bilateral_Medialization_Thyroplasty_for_Presbylaryngis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(17)30343-0 DB - PRIME DP - Unbound Medicine ER -