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Glottic configuration after arytenoid adduction.
Laryngoscope. 1994 Aug; 104(8 Pt 1):965-9.L

Abstract

It has been recently noted that laryngeal paralysis results in a complex alteration of the glottis. The membranous segment of the paralyzed vocal fold is shortened, and, during phonation, patients use hyperfunction to shorten the normal vocal fold to about the same length. Additionally, if the paralyzed vocal fold is not near the midline, the angle between the membranous and cartilaginous segments of the vocal fold is decreased, resulting in a "posterior" gap which cannot be closed by hyperadduction of the normal side. To determine whether arytenoid adduction addresses these problems, videolaryngoscopy was analyzed in 11 patients before and after surgery, and results were compared to patient satisfaction and acoustic and aerodynamic assessment. The posterior gap and glottic competence were improved in all patients, but only 6 had improvement in symptoms. Two had persistent vocal fold bowing but achieved good function after Teflon injection. Three patients, all with paralysis for more than 20 years, had no increase in vocal fold length and very little subjective vocal improvement. Arytenoid adduction is most effective in acute cases. Poor functional results in chronic paralysis are related to failure to achieve vocal fold lengthening, presumably due to soft-tissue contracture.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University of Tennessee, Memphis, College of Medicine 38163.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

8052082

Citation

Woodson, G E., and T Murray. "Glottic Configuration After Arytenoid Adduction." The Laryngoscope, vol. 104, no. 8 Pt 1, 1994, pp. 965-9.
Woodson GE, Murray T. Glottic configuration after arytenoid adduction. Laryngoscope. 1994;104(8 Pt 1):965-9.
Woodson, G. E., & Murray, T. (1994). Glottic configuration after arytenoid adduction. The Laryngoscope, 104(8 Pt 1), 965-9.
Woodson GE, Murray T. Glottic Configuration After Arytenoid Adduction. Laryngoscope. 1994;104(8 Pt 1):965-9. PubMed PMID: 8052082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glottic configuration after arytenoid adduction. AU - Woodson,G E, AU - Murray,T, PY - 1994/8/1/pubmed PY - 1994/8/1/medline PY - 1994/8/1/entrez SP - 965 EP - 9 JF - The Laryngoscope JO - Laryngoscope VL - 104 IS - 8 Pt 1 N2 - It has been recently noted that laryngeal paralysis results in a complex alteration of the glottis. The membranous segment of the paralyzed vocal fold is shortened, and, during phonation, patients use hyperfunction to shorten the normal vocal fold to about the same length. Additionally, if the paralyzed vocal fold is not near the midline, the angle between the membranous and cartilaginous segments of the vocal fold is decreased, resulting in a "posterior" gap which cannot be closed by hyperadduction of the normal side. To determine whether arytenoid adduction addresses these problems, videolaryngoscopy was analyzed in 11 patients before and after surgery, and results were compared to patient satisfaction and acoustic and aerodynamic assessment. The posterior gap and glottic competence were improved in all patients, but only 6 had improvement in symptoms. Two had persistent vocal fold bowing but achieved good function after Teflon injection. Three patients, all with paralysis for more than 20 years, had no increase in vocal fold length and very little subjective vocal improvement. Arytenoid adduction is most effective in acute cases. Poor functional results in chronic paralysis are related to failure to achieve vocal fold lengthening, presumably due to soft-tissue contracture. SN - 0023-852X UR - https://www.unboundmedicine.com/medline/citation/8052082/Glottic_configuration_after_arytenoid_adduction_ L2 - https://doi.org/10.1288/00005537-199408000-00010 DB - PRIME DP - Unbound Medicine ER -