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Voice outcomes following medialization laryngoplasty with and without arytenoid adduction.
Laryngoscope. 2019 08; 129(8):1876-1881.L

Abstract

OBJECTIVE

Voice outcomes following medialization laryngoplasty (ML) for unilateral vocal fold paralysis (UVFP) were compared to those who underwent ML plus arytenoid adduction (AA) (ML+AA).

METHODS

Single institution retrospective review of patients with UVFP undergoing ML and ML+AA (2009-2017). Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative Voice Handicap Index-10 (VHI-10) and Consensus Perceptual Auditory Evaluation of Voice (CAPE-V) were assessed.

RESULTS

Of 236 patients, 119 met study criteria. Of those, 70 (59%) underwent ML and 49 (41%) underwent ML+AA. Significant differences between groups at baseline were found for age at time of thyroplasty (P = 0.046), VHI-10 scores (P < 0.001), and CAPE-V scores (P = 0.007). Baseline VHI-10 scores for ML+AA (28 ± 7) were greater than those for ML alone (24 ± 7). At 12 months, overall VHI-10 scores improved compared to baseline for both groups (ML+AA = 9 ± 7, ML = 16 ± 9); however, there was greater improvement for the ML+AA group compared to ML group (P = 0.001). CAPE-V scores at 3 or 12 months improved, but differences between the groups were not statistically significant once controlled for covariates.

CONCLUSION

Based on current findings, patients who undergo ML+AA likely have greater voice handicap at baseline compared to those undergoing ML alone. Patients selected for ML+AA improve as much or more than those who underwent ML alone. This highlights the importance of appropriate selection of candidates for AA.

LEVEL OF EVIDENCE

4 Laryngoscope, 129:1876-1881, 2019.

Authors+Show Affiliations

Department of Otorhinolaryngology, Rochester, Minnesota, U.S.A.Department of Otorhinolaryngology, Rochester, Minnesota, U.S.A.Department of Otorhinolaryngology, Rochester, Minnesota, U.S.A.Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, U.S.A.Department of Otorhinolaryngology, Rochester, Minnesota, U.S.A.

Pub Type(s)

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

Language

eng

PubMed ID

30582612

Citation

Zimmermann, Terence M., et al. "Voice Outcomes Following Medialization Laryngoplasty With and Without Arytenoid Adduction." The Laryngoscope, vol. 129, no. 8, 2019, pp. 1876-1881.
Zimmermann TM, Orbelo DM, Pittelko RL, et al. Voice outcomes following medialization laryngoplasty with and without arytenoid adduction. Laryngoscope. 2019;129(8):1876-1881.
Zimmermann, T. M., Orbelo, D. M., Pittelko, R. L., Youssef, S. J., Lohse, C. M., & Ekbom, D. C. (2019). Voice outcomes following medialization laryngoplasty with and without arytenoid adduction. The Laryngoscope, 129(8), 1876-1881. https://doi.org/10.1002/lary.27684
Zimmermann TM, et al. Voice Outcomes Following Medialization Laryngoplasty With and Without Arytenoid Adduction. Laryngoscope. 2019;129(8):1876-1881. PubMed PMID: 30582612.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voice outcomes following medialization laryngoplasty with and without arytenoid adduction. AU - Zimmermann,Terence M, AU - Orbelo,Diana M, AU - Pittelko,Rebecca L, AU - Youssef,Stephanie J, AU - Lohse,Christine M, AU - Ekbom,Dale C, Y1 - 2018/12/24/ PY - 2018/10/22/accepted PY - 2018/12/26/pubmed PY - 2019/8/21/medline PY - 2018/12/25/entrez KW - Consensus Perceptual Auditory Evaluation of Voice KW - Medialization laryngoplasty KW - Voice Handicap Index-10 KW - arytenoid adduction SP - 1876 EP - 1881 JF - The Laryngoscope JO - Laryngoscope VL - 129 IS - 8 N2 - OBJECTIVE: Voice outcomes following medialization laryngoplasty (ML) for unilateral vocal fold paralysis (UVFP) were compared to those who underwent ML plus arytenoid adduction (AA) (ML+AA). METHODS: Single institution retrospective review of patients with UVFP undergoing ML and ML+AA (2009-2017). Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative Voice Handicap Index-10 (VHI-10) and Consensus Perceptual Auditory Evaluation of Voice (CAPE-V) were assessed. RESULTS: Of 236 patients, 119 met study criteria. Of those, 70 (59%) underwent ML and 49 (41%) underwent ML+AA. Significant differences between groups at baseline were found for age at time of thyroplasty (P = 0.046), VHI-10 scores (P < 0.001), and CAPE-V scores (P = 0.007). Baseline VHI-10 scores for ML+AA (28 ± 7) were greater than those for ML alone (24 ± 7). At 12 months, overall VHI-10 scores improved compared to baseline for both groups (ML+AA = 9 ± 7, ML = 16 ± 9); however, there was greater improvement for the ML+AA group compared to ML group (P = 0.001). CAPE-V scores at 3 or 12 months improved, but differences between the groups were not statistically significant once controlled for covariates. CONCLUSION: Based on current findings, patients who undergo ML+AA likely have greater voice handicap at baseline compared to those undergoing ML alone. Patients selected for ML+AA improve as much or more than those who underwent ML alone. This highlights the importance of appropriate selection of candidates for AA. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:1876-1881, 2019. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/30582612/Voice_outcomes_following_medialization_laryngoplasty_with_and_without_arytenoid_adduction_ L2 - https://doi.org/10.1002/lary.27684 DB - PRIME DP - Unbound Medicine ER -