Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis

Shi, Jianhui; Chen, S; D, Chen; Wang, W; Xia, Siwen; Zheng, Hongliang

doi:10.1017/s0022215110002434

Cited by 5 publications

(11 citation statements)

References 22 publications

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“…The 4 studies using this outcome all noted improvement, with a reduction of 6 points, 44 4.5 points, 12 1 point, 45 and 4.76 points 41 . Seven studies indicated improvement in dysphagia and/or aspiration as a percentage of the cohort without indication of a specific quantitative outcome measure 19,23,25,31–33 . In these studies, authors indicated that improvement was based on clinical assessment by the surgeon and/or speech pathologist after surgery at a defined interval, but specific methodology was not stipulated.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven studies had sufficient data to be in the quantitative analysis of treatment success, which encompassed 293 subjects/medialization procedures. 19,25,27,[31][32][33][34][35][39][40][41] Only studies that reported subject-level outcome data stratified by procedure were included. An analysis of dysphagia outcomes from LR procedures could not be performed because just 7 subjects with dysphagia underwent LR in the studies.…”

Section: Quantitative Analysis Of Treatment Successmentioning

confidence: 99%

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Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

Coulter¹,

Marvin²,

Brigger

et al. 2022

Otolaryngol.--head neck surg.

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Objective To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility (UVFI) in adults. Data Sources Ovid MEDLINE, Embase, Web of Science, and Cochrane Central. Review Methods A structured literature search was utilized, and a 2-researcher systematic review was performed following PRISMA guidelines. Extractable data were pooled, and a quantitative analysis was performed with a random effects model to analyze treatment outcome and complications by procedure. Results A total of 416 publications were screened and 26 met inclusion criteria. Subjects encompassed 959 patients with UVFI who underwent 916 procedures (n = 547, injection laryngoplasty; n = 357, laryngeal framework surgery; n = 12, laryngeal reinnervation). An overall 615 were identified as having dysphagia as a result of UVFI and had individually extractable outcome data, which served as the basis for a quantitative meta-analysis. In general, dysphagia outcomes after all medialization procedures were strongly positive. Quantitative analysis demonstrated a success rate estimate of 90% (95% CI, 75%-100%) for injection laryngoplasty and 92% (95% CI, 87%-97%) for laryngeal framework surgery. The estimated complication rate was 7% (95% CI, 2%-13%) for injection laryngoplasty and 15% (95% CI, 10%-20%) for laryngeal framework surgery, with minor complications predominating. Although laryngeal reinnervation could not be assessed quantitatively due to low numbers, qualitative analysis demonstrated consistent benefit for a majority of patients for each procedure. Conclusion Dysphagia due to UVFI can be improved in a majority of patients with surgical procedures intended to improve glottal competence, with a low risk of complications. Injection laryngoplasty and laryngeal framework surgery appear to be efficacious and safe, and laryngeal reinnervation may be a promising new option for select patients.

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Section: Resultsmentioning

confidence: 99%

Section: Quantitative Analysis Of Treatment Successmentioning

confidence: 99%

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

Coulter¹,

Marvin²,

Brigger

et al. 2022

Otolaryngol.--head neck surg.

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show abstract

“…Since first described by Isshiki et al [9] in 1978, arytenoid adduction resulted in better correcting a large posterior glottal gap and vertical differences of the 2 vocal folds [10]. As the 3-dimensional movement of arytenoid was relatively complicated in phonation, the traditional Isshiki arytenoid adduction operation may generate unsatisfactory voice quality outcomes in some patients [6, 8]. Meanwhile, compared with medialization thyroplasty, the disadvantages of increase in overall complications and operating time also restricted the widespread of arytenoid adduction operation [11].…”

Section: Introductionmentioning

confidence: 99%

“…However, none of these operations demonstrate to be definitely superior over the others [6]. Injection laryngoplasty treatment for UVFP often do not guarantee long-term effectiveness and widespread acceptance, and the traditional Type I thyroplasty cannot effectively correct differences in the levels of the 2 vocal folds [6][7][8]. Since first described by Isshiki et al [9] in 1978, arytenoid adduction resulted in better correcting a large posterior glottal gap and vertical differences of the 2 vocal folds [10].…”

Section: Introductionmentioning

confidence: 99%

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

Liu

Qiu

Zhang

et al. 2021

ORL

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Introduction: 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. Methods: 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. Results: 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 (p < 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. Conclusion: 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.

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“…The optimal rehabilitation period after UVFP is within one year after surgery, so timely and effective treatment may help patients to restore voice function. Many surgical treatments and voice training methods for UVFP have been reported for those who suffer from UVFP in a paramedian position and if they do not recover within 6 months, another surgery is needed, including intracordal injection, arytenoid adduction, laryngoplasty, transplantation or decompression of the RLN [10][11][12][13][14][15][16][17][18][19]. These surgeries could make the affected VF side move to the midline, promoting glottal closure and improving vocal function.…”

Section: Introductionmentioning

confidence: 99%

Liuzijue Qigong, a New Method of Voice Training after Thyroidectomy Due to Unilateral Vocal Fold Paralysis: A Case Study

Tang¹,

Li²,

Yu³

et al. 2017

Otolaryngol

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Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis

Abstract: Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.

Cited by 5 publications

References 22 publications

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility: A Systematic Review and Meta‐analysis

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

Liuzijue Qigong, a New Method of Voice Training after Thyroidectomy Due to Unilateral Vocal Fold Paralysis: A Case Study

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