Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold Paralysis After Thyroid Surgery

2019 ◽  
Vol 128 (12) ◽  
pp. 1104-1110 ◽  
Author(s):  
Rudolf Reiter ◽  
Adrienne Heyduck ◽  
Thomas Karl Hoffmann ◽  
Sibylle Brosch ◽  
Maria Anna Buchberger ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Vocal Fold ◽  
Complete Recovery ◽  
Vocal Fold Paralysis ◽  
Predicting Factors ◽  
Quality Of Voice ◽  
Thyroid Gland Surgery ◽  
The Voice

Objectives: This study is set to analyze clinicopathological factors predicting the recovery of unilateral vocal fold paralysis (UVP) in patients after thyroid gland surgery. The quality of voice was additionally assessed in these patients. Methods: The charts and videolaryngostroboscopy (VLS) examinations of 84 consecutive patients with a complete UVP after surgery of the thyroid gland were retrospectively reviewed. Patients were divided into 2 groups: patients who fully recovered from vocal fold paralysis and those who failed to recover after a follow-up of 12 months. The quality of voice was analyzed among other things by determining the Voice Handicap Index (VHI). Results: The UVP fully recovered in 52 of 84 (61.9%) patients. Positive mucosal waves (pMWs) on the paralyzed side, a minimal glottic gap <3 mm seen at the first postoperative VLS, age ≤50 years, and surgery duration ≤120 minutes were associated factors for a complete recovery of nerve function. The voice parameters improved independently from recovery of the paralysis in 90% of the patients. Conclusions: For patients with a poor prognosis of a UVP, early intervention may be beneficial. Thus, predicting factors for a full recovery of vocal fold motion would be a valuable tool. In our cohort, about 60% of recoveries could have been predicted using the above-mentioned parameters. Good quality of voice was independently reached in 90% of the cases.

Results of Fascial Augmentation in Unilateral Vocal Fold Paralysis

2002 ◽  
Vol 111 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Petri Reijonen ◽  
Sari Lehikoinen-Söderlund ◽  
Heikki Rihkanen
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Inexpensive Method ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation

The objective of this study was to evaluate the effects on voice quality of augmentation by injection of minced fascia in patients with unilateral vocal fold paralysis. Preoperative and postoperative voice samples from 14 patients (6 men and 8 women; mean age, 59 years) were analyzed by computerized acoustic analysis and blinded perceptual evaluation. Statistically significant improvements were seen in perturbation measurements (jitter and shimmer), noise-to-harmonics ratio, and maximum phonation time. A panel of evaluators rated 10 of the 14 postoperative voices as normal or near-normal. Injection laryngoplasty with minced fascia offers a new, effective, well-tolerated, and inexpensive method to medialize a paralyzed vocal fold. The graft seems to survive well, as indicated by good vocal results with a follow-up ranging from 5 to 32 months.

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.

scholarly journals 5 Years of Diode Laser “Π” Technique for Bilateral Vocal Fold Immobility: A Technique That Improves Airway and Is Friendly to the Voice

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 83S-86S
Author(s):  
Petros D. Karkos ◽  
Marios Stavrakas ◽  
Ioannis Koskinas ◽  
Konstantinos Markou ◽  
Stefanos Triaridis ◽  
...  
Keyword(s):  
Diode Laser ◽  
Vocal Fold ◽  
Assessment Tool ◽  
University Hospital ◽  
Significant Deterioration ◽  
Vocal Fold Immobility ◽  
Quality Of Voice ◽  
Bilateral Vocal Fold Immobility

Background: To demonstrate the efficacy of a new laser surgical technique for bilateral vocal fold immobility (BVFI) on postoperative quality of voice and swallowing. Methods: Prospective study in a tertiary university hospital and a private hospital. Patients with iatrogenic BVFI were included. Outcome measures were Voice Handicap Index 10, 10-item Eating Assessment Tool, flexible laryngoscopy, and success of decannulation. Results: Forty patients with post thyroidectomy BVFI were initially enrolled in our study; only 12 patients returned questionnaires and kept their follow-ups and were included in the study. All patients were successfully decannulated and remain decannulated up to 24-month follow-up. There was a statistically significant improvement in quality of swallowing and no significant deterioration in quality of voice. There was no need for revision up to 24-month follow up. Conclusions: The “Π” technique using diode laser technology is a new and safe technique for BVFI with excellent long-term decannulation rates and improvement in quality of life and swallowing without significant changes in voice quality.

Autologous Fat Injection for Unilateral Vocal Fold Paralysis

1996 ◽  
Vol 105 (8) ◽  
pp. 602-606 ◽  
Author(s):  
Maisie L. Shindo ◽  
Lauren S. Zaretsky ◽  
Dale H. Rice
Keyword(s):  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Fat Injection ◽  
Autologous Fat ◽  
The Voice ◽  
Fat Volume

This study evaluates the efficacy of autologous fat injection for medialization of the paralyzed vocal fold. In 21 patients with unilateral vocal fold paralysis, autologous abdominal fat was injected into the thyroarytenoid muscle to achieve medialization. All patients were followed up with serial videolaryngoscopy and voice evaluation. At 2 months' follow-up, the voice was judged to be excellent in 10 patients, slightly breathy but significantly better than the preoperative voice in 6 patients, and markedly breathy in 4 patients. At 3 to 4 months' follow-up, of the 10 patients with excellent results, 5 maintained an excellent voice, 3 had developed slight breathiness, and 1 had developed severe breathiness. Long-term (6 to 12 months) results were available in 11 patients, and all of them maintained the same voice quality that was noted during the 3 to 4 months' examination. Magnetic resonance imaging of the larynx was obtained in 7 patients at intervals ranging from 1 to 7 months and compared to the baseline scan obtained at 1 week postoperative to assess the amount of fat remaining in the muscle. The images showed fat volume to persist, but a decrease in the fat signal was observed over time. The results suggest that the duration of medialization with autologous fat is variable, but appears to last at least 2 to 3 months. This loss of volume after 3 months seems to be due to absorption of the fat and possibly muscle atrophy. Autologous fat injection is relatively safe and easy to perform, and is an ideal method of temporary vocal fold medialization in patients in whom return of vocal fold function is expected.

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

Long term pathological sequelae of neonatal endotracheal intubation

1989 ◽  
Vol 103 (6) ◽  
pp. 622-625 ◽  
Author(s):  
S. J. Gould ◽  
J. Graham
Keyword(s):  
Endotracheal Intubation ◽  
Cricoid Cartilage ◽  
Subglottic Stenosis ◽  
Corrective Surgery ◽  
Pathological Changes ◽  
Laryngeal Cartilages ◽  
Quality Of Voice

AbstractIn neonates, acquired subglottic stenosis (SGS) is the most serious long term complication of endotracheal intubation. In this case report, we describe the pathological changes in the larynx of a child who died two years after successful treatment, involving corrective surgery, for neonatally acquired SGS. Stenosis, due to dense fibrous connective tissue, was still present at death. However, there was evidence that there had been growth of the laryngeal cartilages. Disruption of the laryngeal cartilages was present anteriorly due to the antecedent surgery but major cricoid cartilage injury secondary to intubation was not seen. The crico-arytenoid joints demonstrated ankylosis and to this was attributed the abnormal quality of voice noted in the child at follow-up. The pathological changes are considered in relation to the pathology of endotracheal intubation and pathogenesis of acquired subglottic stenosis.

Longitudinal analysis of Voice Handicap Index in early glottic cancer patients treated with transoral laser microsurgery: age, gender, stage and time dependence

2019 ◽  
Vol 133 (4) ◽  
pp. 318-323 ◽  
Author(s):  
C Lane ◽  
M Rigby ◽  
R Hart ◽  
J Trites ◽  
E Levi ◽  
...  
Keyword(s):  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer ◽  
Related Quality ◽  
The Voice

AbstractObjectivesTransoral laser microsurgery is an increasingly common treatment modality for glottic carcinoma. This study aimed to determine the effect of age, gender, stage and time on voice-related quality of life using the Voice Handicap Index-10.MethodsPrimary early glottic carcinoma patients treated with transoral laser microsurgery were included in the study. Self-reported Voice Handicap Index testing was completed pre-operatively, three months post-operatively, and yearly at follow-up appointments.ResultsVoice Handicap Index improvement was found to be dependent on age and tumour stage, while no significant differences were found in Voice Handicap Index for gender. Voice Handicap Index score was significantly improved at 12 months and 24 months. Time versus Voice Handicap Index modelling revealed a preference for non-linear over linear regression.ConclusionAge and stage are important factors, as younger patients with more advanced tumours show greater voice improvement post-operatively. Patient's Voice Handicap Index is predicted to have 95 per cent of maximal improvement by 5.5 months post-operatively.

A Clinical Audit of the Investigation and Follow-up of Vocal Fold Paralysis at Rigshospitalet, Denmark

2019 ◽  
Vol 2 (1) ◽  
pp. 52-56
Author(s):  
Lars Iversen ◽  
Jesper Storgård Balle ◽  
Ramon Gordon Jensen
Keyword(s):  
Vocal Fold ◽  
Clinical Audit ◽  
Vocal Fold Paralysis

Arytenoidopexy for bilateral vocal fold paralysis in young children

1996 ◽  
Vol 110 (11) ◽  
pp. 1027-1030 ◽  
Author(s):  
Jean-Michel Triglia ◽  
Jean-François Belus ◽  
Richard Nicollas
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Young Children ◽  
Vocal Fold ◽  
Good Health ◽  
Vocal Fold Paralysis ◽  
Airway Compromise ◽  
Bilateral Vocal Fold Paralysis ◽  
Life Threatening

AbstractThe purpose of this retrospective study was to describe and evaluate the results of arytenoidopexy performed by the external laterocervical approach in 15 consecutive children presenting bilateral vocal fold paralysis causing life-threatening airway compromise. Mean age at the time of surgery was 20 months and mean follow-up was 42 months. At the end of follow-up all patients were in good health and did not need special care for breathing. No abduction movement has been observed on the opposite vocal fold since arytenoidopexy. One failure subsequently required arytenoidectomy. The findings of this study suggest that arytenoidopexy is an effective surgical treatment for life-threatening bilateral vocal fold paralysis in young children.

Sign in / Sign up

Export Citation Format

Share Document