Glottic Closure Patterns: Type I Thyroplasty Versus Type I Thyroplasty With Arytenoid Adduction
| Autor: | Albert L. Merati, Seth H. Dailey, Yolanda D. Heman-Ackah, Adam D. Rubin, Michael M. Johns, Cristina Jackson-Menaldi, Anya J. Li |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Glottis medicine.medical_specialty Voice Quality Visual analogue scale Video Recording Stroboscope Laryngoplasty Speech and Hearing Thyroplasty Phonation otorhinolaryngologic diseases medicine Humans Stroboscopy Closure (psychology) Retrospective Studies business.industry Patient Selection Retrospective cohort study Recovery of Function Middle Aged LPN and LVN Biomechanical Phenomena Surgery Treatment Outcome medicine.anatomical_structure Otorhinolaryngology Arytenoid Adduction Regression Analysis Female business Vocal Cord Paralysis Arytenoid Cartilage |
| Zdroj: | Journal of Voice. 25:259-264 |
| ISSN: | 0892-1997 |
| DOI: | 10.1016/j.jvoice.2009.11.001 |
| Popis: | Summary Objectives/Hypothesis The goal of laryngeal framework surgery in patients with unilateral vocal fold paralysis is to improve glottic closure by medializing the paralyzed vocal fold. Type I thyroplasty (Th) and arytenoid adduction (AA) are two of the most commonly performed procedures. Two of the main rationales for performing an AA are to improve closure of the posterior glottis and correct vertical height discrepancy. The purpose of this study was to evaluate if AA with Th yields better posterior glottic closure and vertical height equality than Th alone. Study Design Retrospective. Methods Using visual analog scales, three blinded reviewers evaluated glottic closure patterns in patients who underwent Th or Th with AA. Pre- and postoperative videostroboscopic examinations of 45 patients with unilateral vocal fold paralysis, who underwent laryngeal framework surgery, were evaluated. Results No significant difference was identified in postoperative scores for midmembranous glottis closure ( P =0.282), closure just anterior to the vocal processes ( P =0.426), respiratory glottis closure ( P =0.158), or vertical height discrepancy ( P =0.113). Conclusions Although larger glottic gaps and vertical height discrepancies may lead some surgeons to predict that an AA is warranted, the usefulness of AA may not always be related to these parameters. Ultimately, voice improvement and not geometry should guide the surgeon's decision making. |
| Databáze: | OpenAIRE |
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