Voice outcomes following medialization laryngoplasty with and without arytenoid adduction. (24th December 2018)

• Record Type: Journal Article
• Authors: Zimmermann, Terence M.; Orbelo, Diana M.; Pittelko, Rebecca L.; Youssef, Stephanie J.; Lohse, Christine M.; Ekbom, Dale C.
• Is Part Of: Laryngoscope. Volume 129:Number 8(2019)
• Page Start: 1876
• Page End: 1881
• Publication Date: 2018-12-24
• Subjects: Medialization laryngoplasty -- arytenoid adduction -- Voice Handicap Index‐10 -- Consensus Perceptual Auditory Evaluation of Voice; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.27684
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objective: Voice outcomes following medialization laryngoplasty (ML) for unilateral vocal fold paralysis (UVFP) were compared to those who underwent ML plus arytenoid adduction (AA) (ML+AA). Methods: Single institution retrospective review of patients with UVFP undergoing ML and ML+AA (2009–2017). Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative Voice Handicap Index‐10 (VHI‐10) and Consensus Perceptual Auditory Evaluation of Voice (CAPE‐V) were assessed. Results: Of 236 patients, 119 met study criteria. Of those, 70 (59%) underwent ML and 49 (41%) underwent ML+AA. Significant differences between groups at baseline were found for age at time of thyroplasty ( P = 0.046), VHI‐10 scores ( P < 0.001), and CAPE‐V scores ( P = 0.007). Baseline VHI‐10 scores for ML+AA (28 ± 7) were greater than those for ML alone (24 ± 7). At 12 months, overall VHI‐10 scores improved compared to baseline for both groups (ML+AA = 9 ± 7, ML = 16 ± 9); however, there was greater improvement for the ML+AA group compared to ML group ( P = 0.001). CAPE‐V scores at 3 or 12 months improved, but differences between the groups were not statistically significant once controlled for covariates. Conclusion: Based on current findings, patients who undergo ML+AA likely have greater voice handicap at baseline compared to those undergoing ML alone. Patients selected for ML+AA improve as much or more than those who underwent ML alone. This highlights the importance of appropriate selection of candidates for AA. Level of Evidence: 4 Laryngoscope, 129:1876–1881, 2019