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A Novel Endoscopic Arytenoid Medialization for Unilateral Vocal Fold Paralysis
Author(s) -
Rovó László,
Ambrus Andrea,
Tóbiás Zoltán,
Wootten Christopher T.,
Bach Ádám
Publication year - 2021
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.29001
Subject(s) - medicine , arytenoid cartilage , vocal fold paralysis , glottis , phonation , laryngeal paralysis , anterior commissure , laryngoplasty , larynx , vocal folds , surgery , paralysis , audiology
Objectives/Hypothesis Arytenoid adduction (AA) has been indicated for unilateral vocal fold paralysis (UVFP) patients with vertical vocal fold height mismatch and/or large posterior glottic gaps that are unable to be adequately addressed by anterior medialization techniques. Although AA offers several advantages over other methods, it is technically challenging and involves significant laryngeal manipulation of the cricoarytenoid joint. A novel, minimally invasive endoscopic arytenoid medialization technique is presented for the closure of the posterior commissure. Study Design Prospective case series. Methods Seventeen consecutive patients were diagnosed and treated with unilateral endoscopic arytenoid medialization (EAM) combined with injection laryngoplasty because of unilateral vocal fold paralysis. Jitter, shimmer, harmonics‐to‐noise ratio (HNR), maximum phonation time (MPT), fundamental frequency (F 0 ), Voice Handicap Index (VHI), peak inspiratory flow (PIF), and quality of life (QoL) were evaluated preoperatively, 1 month, and 1 year after EAM. Results Jitter, shimmer, HNR, and MPT significantly improved and remained stable 1 year after the intervention. F 0 and PIF remained unchanged. Significant improvements in VHI and QoL demonstrated patient satisfaction with voicing and respiratory functions. Conclusions Endoscopic arytenoid medialization is a quick, minimally invasive solution for unilateral vocal fold paralysis. With simultaneous augmentation of the vocal fold, it provides a complete glottic closure along the entire vocal fold in UVFP patients. Level of Evidence 4 Laryngoscope , 131:E903–E910, 2021