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Voice aerodynamics following office-based hyaluronate injection laryngoplasty.
Clin Otolaryngol. 2019 07; 44(4):594-602.CO

Abstract

OBJECTIVES

Neuromuscular control, glottal conformation and aerodynamics are the major factors affecting voice performance. We aimed to characterise the degree to which voice improvements following office-based intracordal hyaluronate injection laryngoplasty (HIL) depend on changes in voice aerodynamics in patients with unilateral vocal fold paralysis (UVFP), by assessing the correlations between these parameters.

DESIGN

Prospective case series.

SETTING

Otolaryngology Clinics in a Medical Center.

PARTICIPANTS

Patients with UVFP within 6 months of their first outpatient visit who received single HIL.

MAIN OUTCOME MEASURES

Videolaryngostroboscopy, aerodynamics and laboratory voice analysis were evaluated at baseline and 1 month after HIL. Quantitative laryngeal electromyography was evaluated at baseline to confirm UVFP.

RESULTS

Seventy-five newly diagnosed patients with UVFP were analysed. The normalised glottal gap area (NGGA) decreased (P < 0.001) (Cohen's dz = 0.94) and all aerodynamic parameters improved (all P < 0.05) (Cohen's dz = 0.38-1.02) following HIL. Patients undergoing thoracic surgery had more profound aerodynamic impairments both before and after HIL. After adjusting for improvements in NGGA, the improvement in aerodynamics was correlated with voice improvement and most notably with maximum phonation time and jitter/shimmer.

CONCLUSIONS

Hyaluronate injection laryngoplasty improved glottal conformation, aerodynamics and voice, highlighting the benefit of early HIL intervention for patients with UVFP. Patients with UVFP caused by thoracic surgery continued to have poorer aerodynamics post-HIL, indicating the importance of speech therapy in these patients.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. School of Medicine, Chang Gung University, Taoyuan, Taiwan. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Department of Physical Medicine and Rehabilitation, 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, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31004468

Citation

Pei, Yu-Cheng, et al. "Voice Aerodynamics Following Office-based Hyaluronate Injection Laryngoplasty." Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, vol. 44, no. 4, 2019, pp. 594-602.
Pei YC, Chuang HF, Wong AMK, et al. Voice aerodynamics following office-based hyaluronate injection laryngoplasty. Clin Otolaryngol. 2019;44(4):594-602.
Pei, Y. C., Chuang, H. F., Wong, A. M. K., & Fang, T. J. (2019). Voice aerodynamics following office-based hyaluronate injection laryngoplasty. Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 44(4), 594-602. https://doi.org/10.1111/coa.13343
Pei YC, et al. Voice Aerodynamics Following Office-based Hyaluronate Injection Laryngoplasty. Clin Otolaryngol. 2019;44(4):594-602. PubMed PMID: 31004468.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Voice aerodynamics following office-based hyaluronate injection laryngoplasty. AU - Pei,Yu-Cheng, AU - Chuang,Hsiu-Feng, AU - Wong,Alice M K, AU - Fang,Tuan-Jen, Y1 - 2019/05/16/ PY - 2018/07/12/received PY - 2019/03/14/accepted PY - 2019/4/21/pubmed PY - 2020/8/4/medline PY - 2019/4/21/entrez KW - aerodynamics KW - glottal gap KW - hyaluronate KW - injection laryngoplasty KW - laryngeal electromyography KW - unilateral vocal fold paralysis SP - 594 EP - 602 JF - Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery JO - Clin Otolaryngol VL - 44 IS - 4 N2 - OBJECTIVES: Neuromuscular control, glottal conformation and aerodynamics are the major factors affecting voice performance. We aimed to characterise the degree to which voice improvements following office-based intracordal hyaluronate injection laryngoplasty (HIL) depend on changes in voice aerodynamics in patients with unilateral vocal fold paralysis (UVFP), by assessing the correlations between these parameters. DESIGN: Prospective case series. SETTING: Otolaryngology Clinics in a Medical Center. PARTICIPANTS: Patients with UVFP within 6 months of their first outpatient visit who received single HIL. MAIN OUTCOME MEASURES: Videolaryngostroboscopy, aerodynamics and laboratory voice analysis were evaluated at baseline and 1 month after HIL. Quantitative laryngeal electromyography was evaluated at baseline to confirm UVFP. RESULTS: Seventy-five newly diagnosed patients with UVFP were analysed. The normalised glottal gap area (NGGA) decreased (P < 0.001) (Cohen's dz = 0.94) and all aerodynamic parameters improved (all P < 0.05) (Cohen's dz = 0.38-1.02) following HIL. Patients undergoing thoracic surgery had more profound aerodynamic impairments both before and after HIL. After adjusting for improvements in NGGA, the improvement in aerodynamics was correlated with voice improvement and most notably with maximum phonation time and jitter/shimmer. CONCLUSIONS: Hyaluronate injection laryngoplasty improved glottal conformation, aerodynamics and voice, highlighting the benefit of early HIL intervention for patients with UVFP. Patients with UVFP caused by thoracic surgery continued to have poorer aerodynamics post-HIL, indicating the importance of speech therapy in these patients. SN - 1749-4486 UR - https://www.unboundmedicine.com/medline/citation/31004468/Voice_aerodynamics_following_office_based_hyaluronate_injection_laryngoplasty_ L2 - https://doi.org/10.1111/coa.13343 DB - PRIME DP - Unbound Medicine ER -