Arytenopexy with medialization thyroplasty and cricothyropexy in the treatment of unilateral vocal fold paralysis: a 15-year experience
, Bernardo Scarioli Oliveira, Mauro Becker Martins Vieira, Flávia Amarante Cardoso, Lívia Bernardi Lopes, Marianna Novaes da Costa Avila, Kênia Rabelo Santana de Farias
Abstract
Introduction: Unilateral vocal fold paralysis can have significant repercussion on quality of life. Several surgical procedures have been designed to improve dysphonia, dysphagia and gagging, with emphasis on type 1 (medialization) thyroplasty and vocal fold injection. Objective: To evaluate our experience with the technique, functional results, and potential complications. Methods: A retrospective study was conducted with a sample of 29 patients submitted to this surgical procedure between 2000 and 2015. All procedures were performed under local anesthesia with sedation, and without intercurrences. Hospitalization time was 24 h on average. Results: None of the patients presented respiratory distress that required tracheostomy. Regarding vocal quality, the results were considered satisfactory or optimal, with high degree of patient satisfaction. With respect to dysphagia, all patients who needed enteral nutrition resumed exclusive peroral diet. Conclusion: Arytenopexy with medialization thyroplasty and cricothyropexy are procedures with low degree of complication that can be performed under local anesthesia with excellent functional results, even in patients with marked posterior glottic gap.
Keywords
References
1. Khadivi E, Akbarian M, Khazaeni K, Salehi M. Outcomes of autologous fat injection laryngoplasty in unilateral vocal cord paralysis. Iran J Otorhinolaryngol. 2016;28(86):215-9. PMid:27429951.
2. Yung KC, Likhterov I, Courey MS. Effect of temporary injection medialization on the rate of permanent medialization laryngoplasty in unilateral vocal fold paralysis patients. Laryngoscope. 2011;121(10):2191-4. http://dx.doi.org/10.1002/lary.21965. PMid:21898421.
3. Bothe C, López M, Quer M, León X, García J, Lop J. Etiology and treatment of vocal fold paralysis: retrospective study of 108 patients. Acta Otorrinolaringol Esp. 2014;65(4):225-30. http://dx.doi.org/10.1016/j.otorri.2014.02.003. PMid:24780305.
4. Isshiki N, Morita H, Okamura H, Hiramoto M. Thyroplasty as a new phonosurgical technique. Acta Otolaryngol. 1974;78(5-6):451-7. http://dx.doi.org/10.3109/00016487409126379. PMid:4451096.
5. Isshiki N, Taira T, Tanabe M. Surgical alteration of the vocal pitch. J Otolaryngol. 1983;12(5):335-40. PMid:6644864.
6. Isshiki N. Functional surgery of the larynx. Kyoto: Kyoto University Medical School; 1977. 207 p.
7. Zeitels SM, Desloge RB, Hillman RE, Bunting GA. Cricothyroid subluxation: a new innovation for enhancing the voice with laryngoplastic phonosurgery. Ann Otol Rhinol Laryngol. 1999;108(12):1126-31. http://dx.doi.org/10.1177/000348949910801206. PMid:10605916.
8. Zeitels SM. New procedures for paralytic dysphonia: adduction arytenopexy, goretex medialization laryngoplasty, and cricothyroid subluxation. Otolaryngol Clin North Am. 2000;33(4):841-54. http://dx.doi.org/10.1016/S0030-6665(05)70247-4. PMid:10918664.
9. Zeitels SM, Mauri M, Dailey SH. Medialization laryngoplasty with gore-tex for voice restoration secondary to glottal incompetence: indications and observations. Ann Otol Rhinol Laryngol. 2003;112(2):180-4. http://dx.doi.org/10.1177/000348940311200213.
10. Heitmiller RF, Tseng E, Jones B. Prevalence of aspiration and laryngeal penetration in patients with unilateral vocal fold motion impairment. Dysphagia. 2000;15(4):184-7. http://dx.doi.org/10.1007/s004550000026. PMid:11014880.
11. Kokong DD, Adoga AA, Bakari A, Okundia PO, Onakoya PA, Nwaorgu O. Prevalence of aspiration and laryngeal penetration in patients with unilateral vocal fold motion impairment. Afr J Med Med Sci. 2014;43(Suppl 1):173-8. PMid:26709328.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email