Premium
Impact of vocal fold augmentation and laryngoplasty on dyspnea in patients with glottal incompetence
Author(s) -
Dion Gregory R.,
Fritz Mark A.,
Teng Stephanie E.,
Marcus Sonya,
Fang Yixin,
Branski Ryan C.,
Amin Milan R.
Publication year - 2018
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.26850
Subject(s) - medicine , cohort , vocal folds , vocal cord dysfunction , context (archaeology) , body mass index , retrospective cohort study , glottis , larynx , cardiology , surgery , physical therapy , paleontology , asthma , biology
Objectives/Hypothesis Given that the vocal folds are active organs of respiration, reports of dyspnea in the context of glottic insufficiency are not uncommon. We hypothesize that improved glottal closure via framework surgery or vocal fold augmentation improves dyspnea symptoms. Study Design Retrospective review. Methods Charts of patients undergoing procedures to correct glottal insufficiency, either via vocal fold augmentation (VFA) or medialization laryngoplasty (ML) between December 2012 and September 2015 were reviewed (n = 189). Modified Borg Dyspnea Scale (MBDS) and Modified Medical Research Council Dyspnea Scale (MMRCDS) data were collected before and after intervention. Age, body mass index (BMI), and sex, as well as pulmonary and cardiac comorbidities were considered. Subgroup analysis was performed on individuals with subjective dyspnea prior to intervention. Results For the entire cohort, differences in the MMRCDS and MBDS were not statistically different pre‐ and postintervention ( P = .20 and P = .12, respectively). Patients with BMI <30 experienced more improvement on the MBDS ( P = .03). Both the MMRCDS and MMBDS improved post‐procedure ( P = .001 and P = .001, respectively) in patients reporting dyspnea prior to intervention. Conclusions Patients with glottic insufficiency and dyspnea prior to intervention to improve glottic closure had a significant reduction in dyspnea following treatment. Conversely, subjects without complaints of dyspnea prior to intervention had variable outcomes with regard to dyspnea symptoms. Additionally, based on data from the entire cohort, VFA or ML did not worsen dyspnea symptoms. These data may assist in counseling and/or selection of patients considered for procedures to improve glottic closure. Level of Evidence 4. Laryngoscope , 128:427–429, 2018