Sex‐based outcomes in type I thyroplasty for nonparalytic glottic incompetence

Farzal, Zainab; Overton, Lewis J.; Farquhar, Douglas R.; Stephenson, Elizabeth D.; Shah, Rupali N.; Buckmire, Robert A.

doi:10.1002/lary.27770

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…Another previous study reported sex differences for GFI for both UVFP and presbylarynges patients after medialization laryngoplasty, but no previous study has reported significant sex differences for airflow, either pre- or post-treatment for either of these diagnoses. 22 This study demonstrated a significant difference in mean airflow based on sex, with a medium effect size. Across all etiologies and diagnoses, females had significantly lower airflows compared to males (Table 1).…”

Section: Discussionmentioning

confidence: 58%

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Predicting Airflow from Measures Sensitive to Mid-cord Glottal Gap During the COVID-19 Pandemic

Niermeyer

Diao

Bielamowicz

et al. 2023

Ann Otol Rhinol Laryngol

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Objectives: To determine if trans-laryngeal airflow, important in assessing vocal function in paresis/paralysis and presbylarynges patients with mid-cord glottal gaps, could be predicted by other measures sensitive to mid-cord glottal gap size but with smaller risks of spreading COVID-19, and if any patient factors need consideration. Methods: Four populations were: unilateral vocal fold paresis/paralysis (UVFP, 148), aging and UVFP (UVFP plus aging, 22), bilateral vocal fold paresis/paralysis without airway obstruction (BVFP, 49), and presbylarynges (66). Five measures were selected from the initial clinic visit: mean airflow from repeated /pi/ syllables, longer of 2 /s/ and 2 /z/ productions, higher of 2 cepstral peak prominence smoothed for vowel /a/ (CPPSa), and Glottal Function Index (GFI). S/Z ratios were computed. Stepwise regression models used 3 measures and 5 patient factors (age, sex, etiology, diagnosis, and potentially impaired power source for voicing) to predict airflow. Results: Log-transformations were required to normalize distributions of airflow and S/Z ratio. The final model revealed age, sex, impaired power source, log-transformed S/Z ratio, and GFI predicted log-transformed airflow ( R2 = .275, F[5,278] = 21.1; P < .001). Conclusions: The amount of variance explained by the model was not high, suggesting adding other predictive variables to the model might increase the variance explained.

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Section: Discussionmentioning

confidence: 58%

“…21 Sex-based differences have been found for GFI ratings in UVFP and presbylarynges patients. 22 Differences in s/z ratios have been found with impaired power source for voicing. [23][24][25] Differences in flow, GFI and s/z ratios have already been demonstrated between diagnoses of UVFP, BVFP, and presbylarynges.…”

Section: Introductionmentioning

confidence: 99%

Predicting Airflow from Measures Sensitive to Mid-cord Glottal Gap During the COVID-19 Pandemic

Niermeyer

Diao

Bielamowicz

et al. 2023

Ann Otol Rhinol Laryngol

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“…Lastly, we found a lowered, but still higher than normal fundamental frequency in males after bilateral medialization thyroplasty, both for atrophy and atrophy with sulcus. This may be an interesting aspect for further research as gender specific outcomes after medialization thyroplasty for non-paralytic glottic incompetence has gained more attention recently, showing female having greater subjective improvement compared to male after surgery [12]. We would also consider to include this aspect in the pre-operative counselling of male patients by informing them that their voices may still be higher pitched after surgery.…”

Section: Discussionmentioning

confidence: 98%

Bilateral medialization thyroplasty in patients with vocal fold atrophy with or without sulcus

Broek

Heijnen

Hendriksma

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose To evaluate voice outcome after bilateral medialization thyroplasty in patients with non-paralytic glottic insufficiency due to vocal fold atrophy with or without sulcus. Methods Retrospective cohort study on 29 patients undergoing bilateral medialization thyroplasty for vocal fold atrophy (14 procedures) or atrophy with sulcus (15 procedures) between October 2012 and November 2017. Voice data were collected and analyzed for the preoperative and the 3-and 12-month postoperative time point according to a standardized protocol, including Voice Handicap Index (VHI)-30 and perceptual, acoustic and aerodynamic parameters. Failure rate was based on number of revisions within 12 months and non-relevant improvement (< 10 points) in VHI-30 at 12 months. Results There was a clinically relevant (≥ 15 points) and statistically significant improvement (p < 0.0001) in the VHI-30 (preoperative: 55.8 points; postoperative at 12 months: 30.9 points). Fundamental frequency for male subjects decreased significantly from 175 to 159 Hz (p = 0.0001). The pre-and post-operative grade of dysphonia was significantly lower in patients with atrophy compared to atrophy and sulcus (mean difference 0.70, p = 0.017). Conclusion Bilateral medialization thyroplasty is a valid treatment option for patients with atrophy with or without sulcus. Outcomes are comparable to other methods reported in literature. However, there is a great need for larger, prospective studies with long-term follow-up to gain more insight into the comparative voice outcomes for the different forms of surgery for patients with glottic incompetence due to atrophy with or without sulcus.

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“…In order to give comparison to other interventions’ effects on the VRQL, conventional speech therapy for presbyphonia patients was able to improve the total VRQL score by 4, 13 and type I thyroplasty improved male patients with glottic incompetence by 20.8. 14…”

Section: Discussionmentioning

confidence: 99%

Voice-Related Quality of Life in Patients with Chronic Rhinosinusitis

Walgama

Borrelli

et al. 2020

Ann Otol Rhinol Laryngol

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Objective: Chronic rhinosinusitis (CRS) has long been associated with vocal dysfunction. However, studies quantifying the presence of voice dysfunction in CRS patients or the effects of functional endoscopic sinus surgery (FESS) are sparse. The goal of this study was to determine the voice-related quality of life in patients undergoing FESS for CRS using the validated Voice Related Quality of Life Survey (VRQL). We correlated the preoperative VRQL scores to the Sino-Nasal Outcome Test (SNOT-22) scores, and we determined the effect of FESS on postoperative VRQL scores. Methods: Consecutive patients undergoing FESS were preoperatively administered both the VRQL and the SNOT-22 surveys. Spearman (ρ) and Pearson ( r) correlation coefficients were calculated. The VRQL was mailed to patients postoperatively between 3 and 6 months. The paired t-test was used to compare pre- and post-FESS scores. Results: A total of 102 patients were enrolled, and 81 patients completed the two surveys. A total of 51 (62.9%) patients had raw VRQL score ≥ 10, signifying presence of significant vocal symptoms. The mean ± standard deviation (SD) raw VRQL score of the entire study population was 12.4 ± 4.6, and the mean SNOT-22 score was 37.8 ± 19.2. The Spearman correlation coefficient between VRQL and the total SNOT-22 score was 0.34 ( P =.002), and the Pearson correlation coefficient was 0.36 ( P = .001). Both correlations were similar, demonstrating that increasing severity of CRS symptoms correlates with decreasing voice-related quality of life (QOL). Seventy patients completed the postoperative survey for an 86% retention rate. Thirty-six of these patients had abnormal preoperative VRQL scores, and these patients improved significantly after FESS. The mean preoperative versus postoperative raw scores were 15.2 ± 5.6 versus 12.5 ± 4.1, respectively ( P = .003). Conclusion: This study demonstrates the increasing presence of vocal complaints with increasing severity of CRS. It also demonstrates that VRQL scores improve after FESS in those patients with preoperative vocal complaints. Level of Evidence: IV

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Sex‐based outcomes in type I thyroplasty for nonparalytic glottic incompetence

Cited by 8 publications

References 23 publications

Predicting Airflow from Measures Sensitive to Mid-cord Glottal Gap During the COVID-19 Pandemic

Predicting Airflow from Measures Sensitive to Mid-cord Glottal Gap During the COVID-19 Pandemic

Bilateral medialization thyroplasty in patients with vocal fold atrophy with or without sulcus

Voice-Related Quality of Life in Patients with Chronic Rhinosinusitis

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