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Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy.
Eur Arch Otorhinolaryngol. 2021 Dec 02 [Online ahead of print]EA

Abstract

PURPOSE

Endoscopic arytenoid abduction lateropexy (EAAL) is a reliable surgical solution for the minimally invasive treatment of bilateral vocal fold palsy (BVFP), providing a stable airway by the lateralization of the arytenoid cartilages with a simple suture. The nondestructive manner of the intervention theoretically leads to higher regeneration potential, thus better voice quality. The study aimed to investigate the respiratory and phonatory outcomes of this treatment concept.

METHODS

61 BVFP patients with significant dyspnea associated with thyroid/parathyroid surgery were treated by unilateral EAAL. Jitter, Shimmer, Harmonics to Noise Ratio, Maximum Phonation Time, Fundamental frequency, Voice Handicap Index, Dysphonia Severity Index, Friedrich's Dysphonia Index, Global-Roughness-Breathiness scale, Quality of Life, and Peak Inspiratory Flow were evaluated 18 months after EAAL.

RESULTS

All patients had a stable and adequate airway during the follow-up. Ten patients (16.4%) experienced complete bilateral motion recovery with objective acoustic parameters in the physiological ranges. Most functional results of the 13 patients (21.3%) with unilateral recovery also reached the normal values. Fifteen patients (24.6%) had unilateral adduction recovery only, with slightly impaired voice quality. Eleven patients (18.0%) had false vocal fold phonation with socially acceptable voice. In 12 patients (19.7%) no significant motion recovery was detected on the glottic level.

CONCLUSION

EAAL does not interfere with the potential regeneration process and meets the most important phoniatric requirements while guaranteeing the reversibility of the procedure-therefore serving patients with transient palsy. Further, a socially acceptable voice quality and an adequate airway are ensured even in cases of permanent bilateral vocal fold paralysis.

Authors+Show Affiliations

Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary.Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary. bach.adam@med.u-szeged.hu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34854971

Citation

Rovó, László, et al. "Functional Results of Endoscopic Arytenoid Abduction Lateropexy for Bilateral Vocal Fold Palsy." European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2021.
Rovó L, Matievics V, Sztanó B, et al. Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy. Eur Arch Otorhinolaryngol. 2021.
Rovó, L., Matievics, V., Sztanó, B., Szakács, L., Pálinkó, D., Wootten, C. T., Pfiszterer, P., Tóbiás, Z., & Bach, Á. (2021). Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy. European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated With the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. https://doi.org/10.1007/s00405-021-07199-1
Rovó L, et al. Functional Results of Endoscopic Arytenoid Abduction Lateropexy for Bilateral Vocal Fold Palsy. Eur Arch Otorhinolaryngol. 2021 Dec 2; PubMed PMID: 34854971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy. AU - Rovó,László, AU - Matievics,Vera, AU - Sztanó,Balázs, AU - Szakács,László, AU - Pálinkó,Dóra, AU - Wootten,Christopher T, AU - Pfiszterer,Péter, AU - Tóbiás,Zoltán, AU - Bach,Ádám, Y1 - 2021/12/02/ PY - 2021/10/12/received PY - 2021/11/22/accepted PY - 2021/12/2/entrez PY - 2021/12/3/pubmed PY - 2021/12/3/medline KW - Bilateral vocal fold palsy KW - Endoscopic arytenoid abduction lateropexy KW - Minimally invasive surgery KW - Voice quality JF - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery JO - Eur Arch Otorhinolaryngol N2 - PURPOSE: Endoscopic arytenoid abduction lateropexy (EAAL) is a reliable surgical solution for the minimally invasive treatment of bilateral vocal fold palsy (BVFP), providing a stable airway by the lateralization of the arytenoid cartilages with a simple suture. The nondestructive manner of the intervention theoretically leads to higher regeneration potential, thus better voice quality. The study aimed to investigate the respiratory and phonatory outcomes of this treatment concept. METHODS: 61 BVFP patients with significant dyspnea associated with thyroid/parathyroid surgery were treated by unilateral EAAL. Jitter, Shimmer, Harmonics to Noise Ratio, Maximum Phonation Time, Fundamental frequency, Voice Handicap Index, Dysphonia Severity Index, Friedrich's Dysphonia Index, Global-Roughness-Breathiness scale, Quality of Life, and Peak Inspiratory Flow were evaluated 18 months after EAAL. RESULTS: All patients had a stable and adequate airway during the follow-up. Ten patients (16.4%) experienced complete bilateral motion recovery with objective acoustic parameters in the physiological ranges. Most functional results of the 13 patients (21.3%) with unilateral recovery also reached the normal values. Fifteen patients (24.6%) had unilateral adduction recovery only, with slightly impaired voice quality. Eleven patients (18.0%) had false vocal fold phonation with socially acceptable voice. In 12 patients (19.7%) no significant motion recovery was detected on the glottic level. CONCLUSION: EAAL does not interfere with the potential regeneration process and meets the most important phoniatric requirements while guaranteeing the reversibility of the procedure-therefore serving patients with transient palsy. Further, a socially acceptable voice quality and an adequate airway are ensured even in cases of permanent bilateral vocal fold paralysis. SN - 1434-4726 UR - https://www.unboundmedicine.com/medline/citation/34854971/Functional_results_of_endoscopic_arytenoid_abduction_lateropexy_for_bilateral_vocal_fold_palsy_ L2 - https://dx.doi.org/10.1007/s00405-021-07199-1 DB - PRIME DP - Unbound Medicine ER -
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