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A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis.
Laryngoscope. 2021 03; 131(3):E903-E910.L

Abstract

OBJECTIVES/HYPOTHESIS

Arytenoid adduction (AA) has been indicated for unilateral vocal fold paralysis (UVFP) patients with vertical vocal fold height mismatch and/or large posterior glottic gaps that are unable to be adequately addressed by anterior medialization techniques. Although AA offers several advantages over other methods, it is technically challenging and involves significant laryngeal manipulation of the cricoarytenoid joint. A novel, minimally invasive endoscopic arytenoid medialization technique is presented for the closure of the posterior commissure.

STUDY DESIGN

Prospective case series.

METHODS

Seventeen consecutive patients were diagnosed and treated with unilateral endoscopic arytenoid medialization (EAM) combined with injection laryngoplasty because of unilateral vocal fold paralysis. Jitter, shimmer, harmonics-to-noise ratio (HNR), maximum phonation time (MPT), fundamental frequency (F0), Voice Handicap Index (VHI), peak inspiratory flow (PIF), and quality of life (QoL) were evaluated preoperatively, 1 month, and 1 year after EAM.

RESULTS

Jitter, shimmer, HNR, and MPT significantly improved and remained stable 1 year after the intervention. F0 and PIF remained unchanged. Significant improvements in VHI and QoL demonstrated patient satisfaction with voicing and respiratory functions.

CONCLUSIONS

Endoscopic arytenoid medialization is a quick, minimally invasive solution for unilateral vocal fold paralysis. With simultaneous augmentation of the vocal fold, it provides a complete glottic closure along the entire vocal fold in UVFP patients.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:E903-E910, 2021.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, University of Szeged, Szeged, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, University of Szeged, Szeged, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, University of Szeged, Szeged, Hungary.Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.Department of Otorhinolaryngology-Head and Neck Surgery, University of Szeged, Szeged, Hungary.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32790084

Citation

Rovó, László, et al. "A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis." The Laryngoscope, vol. 131, no. 3, 2021, pp. E903-E910.
Rovó L, Ambrus A, Tóbiás Z, et al. A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis. Laryngoscope. 2021;131(3):E903-E910.
Rovó, L., Ambrus, A., Tóbiás, Z., Wootten, C. T., & Bach, Á. (2021). A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis. The Laryngoscope, 131(3), E903-E910. https://doi.org/10.1002/lary.29001
Rovó L, et al. A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis. Laryngoscope. 2021;131(3):E903-E910. PubMed PMID: 32790084.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis. AU - Rovó,László, AU - Ambrus,Andrea, AU - Tóbiás,Zoltán, AU - Wootten,Christopher T, AU - Bach,Ádám, Y1 - 2020/08/13/ PY - 2020/03/05/received PY - 2020/07/12/revised PY - 2020/07/19/accepted PY - 2020/8/14/pubmed PY - 2021/3/6/medline PY - 2020/8/14/entrez KW - Arytenoid adduction KW - arytenoid medialization KW - injection laryngoplasty KW - unilateral vocal fold paralysis KW - vocal fold medialization SP - E903 EP - E910 JF - The Laryngoscope JO - Laryngoscope VL - 131 IS - 3 N2 - OBJECTIVES/HYPOTHESIS: Arytenoid adduction (AA) has been indicated for unilateral vocal fold paralysis (UVFP) patients with vertical vocal fold height mismatch and/or large posterior glottic gaps that are unable to be adequately addressed by anterior medialization techniques. Although AA offers several advantages over other methods, it is technically challenging and involves significant laryngeal manipulation of the cricoarytenoid joint. A novel, minimally invasive endoscopic arytenoid medialization technique is presented for the closure of the posterior commissure. STUDY DESIGN: Prospective case series. METHODS: Seventeen consecutive patients were diagnosed and treated with unilateral endoscopic arytenoid medialization (EAM) combined with injection laryngoplasty because of unilateral vocal fold paralysis. Jitter, shimmer, harmonics-to-noise ratio (HNR), maximum phonation time (MPT), fundamental frequency (F0), Voice Handicap Index (VHI), peak inspiratory flow (PIF), and quality of life (QoL) were evaluated preoperatively, 1 month, and 1 year after EAM. RESULTS: Jitter, shimmer, HNR, and MPT significantly improved and remained stable 1 year after the intervention. F0 and PIF remained unchanged. Significant improvements in VHI and QoL demonstrated patient satisfaction with voicing and respiratory functions. CONCLUSIONS: Endoscopic arytenoid medialization is a quick, minimally invasive solution for unilateral vocal fold paralysis. With simultaneous augmentation of the vocal fold, it provides a complete glottic closure along the entire vocal fold in UVFP patients. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E903-E910, 2021. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/32790084/A_Novel_Endoscopic_Arytenoid_Medialization_for_Unilateral_Vocal_Fold_Paralysis_ L2 - https://doi.org/10.1002/lary.29001 DB - PRIME DP - Unbound Medicine ER -