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Arytenoid rotation and nerve‐muscle pedicle transfer in paralytic dysphonia
Author(s) -
Hassan Megahed M.,
Yumoto Eiji,
Ali Baraka M.,
Sanuki Tetsuji,
Kodama Narihiro
Publication year - 2011
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21657
Subject(s) - medicine , breathy voice , phonation , stroboscope , surgery , paralysis , vocal fold paralysis , audiology , electrical engineering , engineering
Objectives/Hypothesis: Our objective was to evaluate the efficacy of modified nerve‐muscle pedicle (NMP) flap transfer combined with arytenoid adduction (AA) (AA + modified NMP) for treatment of unilateral vocal fold paralysis. The patterns of voice outcome assessed using phonatory function tests and auditory perceptual judgments were followed‐up for 2 years. Study Design: Prospective study. Methods: Thirteen subjects among those presented with paralytic dysphonia between March 2002 and December 2008 were treated with AA + modified NMP. The voice outcomes (six objective and two subjective voice parameters) were evaluated preoperatively and in four different time points postoperatively over 2‐years duration. Results: All voice parameters showed initial postoperative improvement. Moreover, five parameters showed significant continuous improvement over the 2‐year follow‐up (maximum phonation time, pitch range, shimmer, and grade overall and breathiness of the grade‐roughness‐breathiness‐asthenia‐strain scale (GRBAS), whereas two parameters revealed continuous improvement over the first 12 to 14 months after surgery (mean flow rate and harmonics‐to‐noise ratio). Conclusions: AA + modified NMP improves both short‐ and long‐term voice outcomes in unilateral vocal fold paralysis patients. Therefore, AA + modified NMP is an effective surgical combination for the treatment of severe paralytic dysphonia.