scholarly journals Modified Arytenoid Adduction Operation for the Treatment of Unilateral Vocal Fold Paralysis

ORL ◽  
2021 ◽  
pp. 1-6
Author(s):  
Chao Liu ◽  
Yuanzheng Qiu ◽  
Xin Zhang ◽  
Yong Liu ◽  
Guo Li ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Fundamental Frequency ◽  
Vocal Fold ◽  
Thyroid Cartilage ◽  
Vocal Fold Paralysis ◽  
Subjective Perception ◽  
Unilateral Vocal Fold Paralysis ◽  
Mean Values ◽  
Arytenoid Adduction ◽  
The Voice

<b><i>Introduction:</i></b> Unilateral vocal fold paralysis (UVFP) was a relative common glottic insufficiency disease; however, a completely satisfactory treatment of UVFP was elusive. This study was aimed to evaluate the surgical efficacy of modified arytenoid adduction with fenestration of the thyroid cartilage in the management of patients with UVFP, including voice and aspiration outcomes, and to summarize the postoperative complications. <b><i>Methods:</i></b> A retrospective analysis was performed on a total of 21 patients who underwent modified arytenoid adduction operation with fenestration of the thyroid cartilage for UVFP from July 2012 to June 2017. The scores of Grade, Roughness, Breathiness, Asthenia, Strain scale (GRBAS), voice self-satisfaction, dynamic laryngoscopy and the voice acoustic data (fundamental frequency [F0], fundamental frequency perturbation [jitter], loudness, amplitude perturbation [shimmer], and maximal phonatory time [MPT], etc.) were statistically analyzed preoperatively and 3–6 months postoperatively. The occurrence of postoperative complications was also summarized. <b><i>Results:</i></b> The voice subjective perception of 21 patients was significantly improved after operation. The rate of voice self-satisfaction was 90.5%. The mean values of voice acoustics parameters were significantly improved. The MPT was significantly longer (<i>p</i> &#x3c; 0.001), and the ratings of postoperative aspiration were significantly decreased compared with the preoperation. Among the 21 patients, 15 cases had sense of laryngeal obstruction, 8 cases had of 1–2° laryngemphraxis (recovered after 10–15 days). There were 2 cases of laryngeal stridor, 1 case of incision infection, 1 case of pharyngeal fistula, and 1 case of falsetto (corrected by voice training). No patient had laryngeal hematoma, neck hematoma, or laryngospasm. <b><i>Conclusion:</i></b> The modified arytenoid adduction operation with fenestration of the thyroid cartilage can significantly improve the vocal function of patients with UVFP and effectively reduce the aspiration, with fewer postoperative complications, less trauma, and more convenient advantages.

Characteristics of the Voice Handicap Index for Patients With Unilateral Vocal Fold Paralysis Who Underwent Arytenoid Adduction

2020 ◽  
Vol 34 (4) ◽  
pp. 649.e1-649.e6 ◽  
Author(s):  
Kenichi Watanabe ◽  
Takeshi Sato ◽  
Yohei Honkura ◽  
Ai Kawamoto-Hirano ◽  
Kazutaka Kashima ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Voice Handicap Index ◽  
Unilateral Vocal Fold Paralysis ◽  
Arytenoid Adduction ◽  
The Voice

Novel Approach of Medialization Thyroplasty with Arytenoid Adduction Performed under General Anesthesia with a Laryngeal Mask

2011 ◽  
Vol 146 (2) ◽  
pp. 266-271 ◽  
Author(s):  
Nicholas W. Stow ◽  
Jennifer W. Lee ◽  
Ian E. Cole
Keyword(s):  
Vocal Fold ◽  
Case Series ◽  
Vocal Fold Paralysis ◽  
Laryngeal Mask ◽  
Unilateral Vocal Fold Paralysis ◽  
Maximum Phonation Time ◽  
Arytenoid Adduction ◽  
Medialization Thyroplasty ◽  
The Voice

Objective. To objectively assess the voice outcomes of patients with unilateral vocal fold paralysis treated with medialization thyroplasty and arytenoid adduction suture. Study Design. Case series of patients who underwent medialization thyroplasty and arytenoid adduction suture. Preoperative and postoperative voice testing was performed and the data were compared by statistical analysis. Setting. Tertiary referral teaching hospital in Sydney, Australia. Subjects. All patients had a unilateral vocal fold paralysis, with a large posterior glottic gap and vocal symptoms affecting their quality of life. Methods. Thirteen patients with a diagnosis of a unilateral vocal fold paralysis with a large posterior glottic gap, vocal symptoms, and total denervation of the vocal fold underwent medialization thyroplasty and arytenoid adduction suture. The surgery was performed in a novel method under a general anesthetic using a laryngeal mask and with direct intraoperative endoscopic feedback. Preoperative and postoperative measures of voice performance were compared, including acoustic analysis (fundamental frequency, speech intensity against quiet and loud background noise, speech rate) and aerodynamic assessment (airflow, maximum phonation time). Results. Medialization thyroplasty with arytenoid adduction suture significantly improved aerodynamic assessment and phonation duration for both male and female subjects overall. There were 2 of 13 treatment failures. Median follow-up time was 6 months. Conclusion. Preliminary results indicate that in selected patients with vocal fold paralysis, medialization thyroplasty with arytenoid adduction suture leads to significant improvements in objective voice measures. Longer follow-up data are required to further quantify the voice outcomes after this procedure.

Traction of Lateral Cricoarytenoid Muscle for Unilateral Vocal Fold Paralysis: Comparison with Isshiki's Original Technique of Arytenoid Adduction

2005 ◽  
Vol 114 (2) ◽  
pp. 132-138 ◽  
Author(s):  
Satoshi Sonoda ◽  
Hideyuki Kataoka ◽  
Takayo Inoue
Keyword(s):  
Vocal Fold ◽  
Thyroid Cartilage ◽  
Vocal Fold Paralysis ◽  
Original Method ◽  
Type I ◽  
Unilateral Vocal Fold Paralysis ◽  
Anatomic Landmarks ◽  
Maximum Phonation Time ◽  
Arytenoid Adduction ◽  
Type I Thyroplasty

Between 1995 and 1997, we performed Isshiki's original method of arytenoid adduction alone or as an adjunct to type I thyroplasty for the treatment of unilateral vocal fold paralysis. From 1997 onward, we performed arytenoid adduction by traction of the lateral cricoarytenoid muscle (Iwamura's method), because it reduces discomfort to the patient and avoids rotation of the thyroid cartilage. Preliminary experiments and surgical procedures involving traction of the lateral cricoarytenoid muscle are described. Of 21 patients with a maximum phonation time of less than 9 seconds, 14 underwent type I thyroplasty as an adjunct to our method of arytenoid adduction and 7 underwent arytenoid adduction alone. Sixteen patients (76%) were able after surgery to extend their maximum phonation time beyond 10 seconds; this result compares favorably with the results of Isshiki's original adduction technique. We describe useful anatomic landmarks for approaching the lateral cricoarytenoid muscle in the hope that more voice surgeons will adopt this approach in the treatment of unilateral vocal fold paralysis.

scholarly journals Acoustic Correlates of Compensatory Adjustments to the Glottic and Supraglottic Structures in Patients with Unilateral Vocal Fold Paralysis

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Luis M. T. Jesus ◽  
Joana Martinez ◽  
Andreia Hall ◽  
Aníbal Ferreira
Keyword(s):  
Standard Deviation ◽  
Fundamental Frequency ◽  
Vocal Fold ◽  
Normal Subjects ◽  
Vocal Fold Paralysis ◽  
Limited Information ◽  
Unilateral Vocal Fold Paralysis ◽  
Acoustic Correlates ◽  
Noise Ratio

The goal of this study was to analyse perceptually and acoustically the voices of patients with Unilateral Vocal Fold Paralysis (UVFP) and compare them to the voices of normal subjects. These voices were analysed perceptually with the GRBAS scale and acoustically using the following parameters: mean fundamental frequency (F0), standard-deviation ofF0, jitter (ppq5), shimmer (apq11), mean harmonics-to-noise ratio (HNR), mean first (F1) and second (F2) formants frequency, and standard-deviation ofF1 andF2 frequencies. Statistically significant differences were found in all of the perceptual parameters. Also the jitter, shimmer, HNR, standard-deviation ofF0, and standard-deviation of the frequency ofF2 were statistically different between groups, for both genders. In the male data differences were also found inF1 andF2 frequencies values and in the standard-deviation of the frequency ofF1. This study allowed the documentation of the alterations resulting from UVFP and addressed the exploration of parameters with limited information for this pathology.

scholarly journals Which Plosive Consonant Is More Useful for the Aerodynamic Analysis of Pathologic Voice?

2020 ◽  
Vol 13 (2) ◽  
pp. 179-185
Author(s):  
Yong Tae Hong ◽  
Phan Huu Ngoc Minh ◽  
Ki Hwan Hong
Keyword(s):  
Vocal Fold ◽  
Correlation Coefficients ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Acoustic Parameters ◽  
Mean Values ◽  
Aerodynamic Analysis ◽  
Different Types ◽  
Aerodynamic Parameters ◽  
The Mean

Objectives. Both acoustic and aerodynamic analyses are essential to evaluate the phonetic characteristics of voice pathology. The purpose of the study is to determine the magnitude of their correlation with the different types of bilabial plosive consonants.Methods. A controlled prospective study of 35 patients diagnosed with unilateral vocal fold paralysis was performed. The sustained vowel /a/ and bilabial voiceless consonants were used. Three common acoustic parameters were measured from a sustained vowel /a/ and aerodynamic parameters from a set of syllables /pi/, /p<sup>h</sup>i/, and /p’i/. We determined the correlation coefficients between acoustic and aerodynamic measurements for the bilabial plosive consonants /pi/, /p<sup>h</sup>i/, and /p’i/.Results. The mean values of acoustic parameters were higher than the thresholds of pathology. The mean values of aerodynamic parameters varied according to the types of consonants. The correlation between acoustic and aerodynamic parameters was significantly larger with the consonant /p<sup>h</sup>i/ compared with the consonants /p’/ and /p/. The magnitudes of correlation were higher with the consonant /p<sup>h</sup>i/ compared with the consonants /p’/ and /p/.Conclusion. The plosive consonant /p<sup>h</sup>i/ may represent a more valuable investigative consonant than the consonants /p/ or /p’/ for aerodynamic analysis of voice pathology, especially in patients with unilateral vocal fold paralysis.

Role of early voice therapy in patients affected by unilateral vocal fold paralysis

2007 ◽  
Vol 122 (9) ◽  
pp. 936-941 ◽  
Author(s):  
L D'Alatri ◽  
S Galla ◽  
M Rigante ◽  
O Antonelli ◽  
S Buldrini ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Profile Analysis ◽  
Functional Results ◽  
Behavioural Therapy ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Rehabilitation Service ◽  
Unilateral Vocal Fold Paralysis ◽  
Behavioural Treatment ◽  
Mean Values

AbstractObjective:To evaluate the functional results obtained after voice therapy in patients with unilateral vocal fold paralysis caused by different aetiologies.Design:Prospective analysis of the outcome of unilateral vocal fold paralysis cases treated at our speech and language rehabilitation service from November 2003 to January 2006. Thirty cases underwent behavioural treatment, between two and six weeks after unilateral vocal fold paralysis onset. A multi-dimensional assessment was carried out before, immediately after and six months after treatment.Results:After behavioural therapy, the prevalence of complete glottal closure increased significantly (p < 0.05). Subjects' pre-therapy mean values for jitter, shimmer and noise-to-harmonic ratio were statistically significantly different from those taken both immediately and six months after treatment (p < 0.05). The mean values for voice turbulence index significantly improved only six months after therapy (0.08 vs 0.04). At both post-treatment assessments, voice range profile analysis showed a significant decrease of lowest voice frequency and a significant increase of the number of semitones (p < 0.05). Mean values for grade, instability, breathiness, asthenia and voice handicap index scores were significantly decreased both immediately and six months after treatment, compared with pre-treatment values (p < 0.05).Conclusions:Early voice therapy may enable significant improvement in vocal function, allowing the patient to avoid surgery.

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