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Arytenoid adduction as an adjunct to type I thyroplasty for unilateral vocal cord paralysis.
Head Neck. 1999 Jan; 21(1):52-9.HN

Abstract

BACKGROUND

Surgical management of unilateral vocal cord paralysis has evolved over the last three decades. The recent use of type I thyroplasty has resulted in improvements in voice, swallowing, and respiration. The study was performed to evaluate our experience in 28 patients undergoing arytenoid adduction as part of their surgical rehabilitation of unilateral vocal cord paralysis.

METHODS

Patients undergoing arytenoid adduction with or without silastic medialization for unilateral vocal cord paralysis were entered into a prospective data base. Evaluation included symptomatic improvement in hoarseness, aspiration, dysphagia, dyspnea, and the radiographic documentation of pneumonia. Objective evaluation included mean phonatory air flow and acoustic analysis. Complications associated with surgery were recorded.

RESULTS

A satisfactory result was obtained in 27 of 28 (96%) patients. By symptom, improvement in hoarseness was evident in 96%, dyspnea 80%, dysphagia 94%, and aspiration 84%. Improvements in phonatory flow rate (p < .001), estimated mean laryngeal airway resistance (p < .001), and maximally prolonged phonation (p < .01) were identified. Complications occurred in 18% and consisted of local wound sepsis (n = 1), hematoma (n = 1), seroma (n = 1), and transient airway edema (n = 2). There were no episodes of airway obstruction requiring tracheostomy or implant extrusion.

CONCLUSIONS

Arytenoid adduction as part of type I thyroplasty is a safe and effective procedure. Subjective analysis confirms marked improvement in laryngeal function in the form of speech, swallowing, and respiration. Objective analysis confirms improvement in voice parameters. Future directions will focus on determination of those patients best served by arytenoid adduction.

Authors+Show Affiliations

Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9890351

Citation

Kraus, D H., et al. "Arytenoid Adduction as an Adjunct to Type I Thyroplasty for Unilateral Vocal Cord Paralysis." Head & Neck, vol. 21, no. 1, 1999, pp. 52-9.
Kraus DH, Orlikoff RF, Rizk SS, et al. Arytenoid adduction as an adjunct to type I thyroplasty for unilateral vocal cord paralysis. Head Neck. 1999;21(1):52-9.
Kraus, D. H., Orlikoff, R. F., Rizk, S. S., & Rosenberg, D. B. (1999). Arytenoid adduction as an adjunct to type I thyroplasty for unilateral vocal cord paralysis. Head & Neck, 21(1), 52-9.
Kraus DH, et al. Arytenoid Adduction as an Adjunct to Type I Thyroplasty for Unilateral Vocal Cord Paralysis. Head Neck. 1999;21(1):52-9. PubMed PMID: 9890351.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arytenoid adduction as an adjunct to type I thyroplasty for unilateral vocal cord paralysis. AU - Kraus,D H, AU - Orlikoff,R F, AU - Rizk,S S, AU - Rosenberg,D B, PY - 1999/1/16/pubmed PY - 2000/6/20/medline PY - 1999/1/16/entrez SP - 52 EP - 9 JF - Head & neck JO - Head Neck VL - 21 IS - 1 N2 - BACKGROUND: Surgical management of unilateral vocal cord paralysis has evolved over the last three decades. The recent use of type I thyroplasty has resulted in improvements in voice, swallowing, and respiration. The study was performed to evaluate our experience in 28 patients undergoing arytenoid adduction as part of their surgical rehabilitation of unilateral vocal cord paralysis. METHODS: Patients undergoing arytenoid adduction with or without silastic medialization for unilateral vocal cord paralysis were entered into a prospective data base. Evaluation included symptomatic improvement in hoarseness, aspiration, dysphagia, dyspnea, and the radiographic documentation of pneumonia. Objective evaluation included mean phonatory air flow and acoustic analysis. Complications associated with surgery were recorded. RESULTS: A satisfactory result was obtained in 27 of 28 (96%) patients. By symptom, improvement in hoarseness was evident in 96%, dyspnea 80%, dysphagia 94%, and aspiration 84%. Improvements in phonatory flow rate (p < .001), estimated mean laryngeal airway resistance (p < .001), and maximally prolonged phonation (p < .01) were identified. Complications occurred in 18% and consisted of local wound sepsis (n = 1), hematoma (n = 1), seroma (n = 1), and transient airway edema (n = 2). There were no episodes of airway obstruction requiring tracheostomy or implant extrusion. CONCLUSIONS: Arytenoid adduction as part of type I thyroplasty is a safe and effective procedure. Subjective analysis confirms marked improvement in laryngeal function in the form of speech, swallowing, and respiration. Objective analysis confirms improvement in voice parameters. Future directions will focus on determination of those patients best served by arytenoid adduction. SN - 1043-3074 UR - https://www.unboundmedicine.com/medline/citation/9890351/Arytenoid_adduction_as_an_adjunct_to_type_I_thyroplasty_for_unilateral_vocal_cord_paralysis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=1043-3074&amp;date=1999&amp;volume=21&amp;issue=1&amp;spage=52 DB - PRIME DP - Unbound Medicine ER -