Multidimensional Voice Outcomes After Type I Gore‐Tex Thyroplasty in Patients With Nonparalytic Glottic Incompetence

Objectives/Hypothesis Nonparalytic glottic incompetence ( GI ) encompasses a variety of laryngeal pathologies, and vocal outcome data for this group is limited. We report a subgroup analysis of validated, subjective, and perceptual voice outcome measures: voice‐related quality of life ( VRQOL ), Glottal Function Index ( GFI ), and GRBAS (grade, roughness, breathiness, asthenia, and strain), after type I Gore‐Tex thyroplasty ( GTP ) in patients with vocal fold paresis ( VFP ), hypomobility, scar, and atrophy. Study Design Retrospective review. Methods Forty‐eight patients with nonparalytic GI treated with GTP were reviewed. Patients were grouped according to primary diagnosis: VFP (n=12), hypomobility (n=20), scar (n=7), and atrophy (n=9). Voice outcome measures ( VRQOL , GFI , and GRBAS ) obtained during the initial evaluation and the most recent follow‐up were collected and analyzed. Results The median change in VRQOL was significant for each subgroup (all P <.03). Hypomobility and VFP patients demonstrated significantly improved GFI scores postoperatively ( P =.0002 and .008, respectively); atrophy and scar groups did not. All groups, with the exception of scar patients ( P =.13), showed significant improvement in perceptual scores. Increases in VRQOL moderately correlated with decreases in GFI (rho=−0.52). Conclusions Regardless of etiology, patients with nonparalytic GI demonstrated improved subjective and perceptual measures following GTP . Although showing trends toward improvement, vocal fold scar patients performed worse than all other subgroups across all three voice outcome measures. Level of Evidence 4. Laryngoscope , 2013