Outcomes in two patients with vocal fold palsy who underwent revision arytenoid adduction surgery

2019 ◽  
Vol 133 (11) ◽  
pp. 1017-1020 ◽  
Author(s):  
K Matsushima ◽  
H Matsui ◽  
S Ohira ◽  
K Matsuura
Keyword(s):  
Surgical Procedures ◽  
Vocal Fold ◽  
Index Procedure ◽  
Fixation Position ◽  
Arytenoid Adduction ◽  
Vocal Fold Palsy

AbstractObjectiveThis study investigated the position of adduction thread attachment, pulling direction and fixation position in revision arytenoid adduction surgery performed in two patients with left vocal fold palsy in whom satisfactory speech improvement had not been obtained by arytenoid adduction and type 1 thyroplasty.MethodsRevision arytenoid adduction surgery was performed with the vocal fold in the midline position in both cases. A type 1 thyroplasty procedure was subsequently added in one case because of worsened quality of speech following arytenoid adduction.Results and conclusionAlthough the arytenoid adduction procedure is conceptually well established, there is still room for debate concerning the actual surgical procedures used. The technique described in this report is effective, suggesting that it is worthy of recognition as an index procedure.

Impact of speech therapy on the improvement of voice quality in patients with unilateral vocal fold paralysis

2018 ◽  
Vol 7 (4) ◽  
pp. 1-7
Author(s):  
Anna Kuligowska ◽  
Barbara Jamróz ◽  
Joanna Chmielewska ◽  
Katarzyna Jędra ◽  
Tomasz Czernicki ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Speech Therapy ◽  
Acoustic Analysis ◽  
Vocal Tract ◽  
Voice Quality ◽  
Maximum Phonation Time ◽  
Before And After ◽  
Vocal Fold Palsy ◽  
The Voice

Aim of study: Evaluation of the speech therapy on voice quality in patients with unilateral vocal fold palsy. Material and methods: The study group included 11 patients, 8 women and 3 men, in age between 16 to 72 years, with unilateral vocal fold palsy, diagnosed in ENT Department of Warsaw Medical University between 2017-2018. Each person completed questionnaires: the voice disability self-assessment scale (VHI), the voice-based quality of life (VRQoL) scale, the vocal tract discomfort scale (VTD). All questionnaires were completed twice, before and after the voice therapy. In addition, the acoustic analysis of the voice, the assessment of the maximum phonation time and the breathing tract were performed twice in each patient. Each of the patients had a voice rehabilitation consisting of a series of 10 meetings. Results: Statistical analysis of the results of maximum phonation time, the self-assessment of voice disability, the quality of life depending on the voice, discomfort of the vocal tract voice acoustic analysis showed statistically significant differences in the results before and after rehabilitation (p <0.005). In addition, the improvement of the respiratory tract was observed in the majority of patients. Conclusions: Speech therapy significantly affects the voice quality of patients with unilateral laryngeal nerve palsy.

Early results for treatment of unilateral vocal fold palsy with injection medialisation under local anaesthetic

2009 ◽  
Vol 123 (8) ◽  
pp. 873-876 ◽  
Author(s):  
R Pratap ◽  
P Mehta ◽  
B Blagnys ◽  
P Q Montgomery
Keyword(s):  
Local Anaesthetic ◽  
Vocal Fold ◽  
Voice Quality ◽  
Therapy Outcome ◽  
Collagen Injection ◽  
Early Results ◽  
Vocal Fold Palsy ◽  
Quality Of Voice ◽  
Perceptual Assessment

AbstractBackground:The diagnosis and treatment of unilateral vocal fold palsy is a common part of otolaryngology practice. In those patients in whom resolution of symptoms is slow, the resulting dysphonia can have a dramatic effect on the patient's quality of voice and life. We have previously described the procedure of direct phonoplasty under local anaesthesia using the transnasal laryngoesophagoscope.Objective:To examine the subjective and objective data for the first five patients to undergo this procedure, in the form of laryngographic speech analysis, perceptual assessment and therapy outcome measures.Results:Analysis showed a statistically significant improvement in voice quality, in all the above assessment categories, following local anaesthetic direct phonoplasty using the transnasal laryngoesophagoscope.Conclusion:Collagen injection via transnasal flexible laryngoesophagoscopy is a particularly useful technique for treating vocal fold medialisation, especially in palliative care patients and those with shortened life expectancy.

End-to-end anastomosis in the management of laryngotracheal defects

2017 ◽  
Vol 131 (5) ◽  
pp. 447-454 ◽  
Author(s):  
E D Gozen ◽  
M Yener ◽  
Z B Erdur ◽  
E Karaman
Keyword(s):  
Surgical Procedures ◽  
Granulation Tissue ◽  
Vocal Fold ◽  
Laryngotracheal Stenosis ◽  
Thyroid Malignancy ◽  
Operative Complications ◽  
Vocal Fold Palsy ◽  
Grade Ii ◽  
End To End ◽  
Grade Iii

AbstractObjective:To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection.Methods:A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis.Results:Length of stenosis was 1.7–4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures included tracheotracheal end-to-end anastomosis (n= 4), cricotracheal anastomosis (n= 2) and thyrotracheal anastomosis (n= 6). Patients with invasive thyroid malignancy underwent segmental resection of the involved segment with tumour-free margins, and tracheal or cricotracheal end-to-end anastomosis. Successful decannulation was achieved in 13 patients (93 per cent). Post-operative complications were: wound infection (n= 1), subcutaneous emphysema (n= 1), temporary unilateral vocal fold palsy (n= 1), granulation tissue development (n= 1), and restenosis (n= 2).Conclusion:End-to-end anastomosis can be used safely and successfully in the management of advanced laryngotracheal stenosis and wide laryngotracheal defects. Greater success can be achieved using previously described surgical rules and laryngotracheal release manoeuvres.

Arytenoid asymmetry: Is it the most predictive parameter for arytenoid adduction in unilateral vocal fold paralysis?

2021 ◽  
pp. 1-9
Author(s):  
J R Menon ◽  
A S Mathew ◽  
S Nath
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Arytenoid Adduction ◽  
Operative Planning ◽  
Group 2 ◽  
Retrospective Comparative Study ◽  
Two Parameters ◽  
Vertical Level

Abstract Objective The aim of this study was to establish arytenoid asymmetry as a pre-operative predictive parameter for arytenoid adduction surgery in unilateral vocal fold paralysis and thereafter identify the most predictive parameter for arytenoid adduction among the established parameters. Methods A retrospective comparative study was undertaken. The ‘arytenoid asymmetry angle’ formed between skewed ‘glottic’ and ‘interarytenoid’ axes (traced along the plane of closure of the membranous and cartilaginous glottis, respectively) was quantified in pre-operative laryngoscopic images of 85 adults with unilateral vocal fold paralysis who underwent either type 1 thyroplasty (group 1) or type 1 thyroplasty with arytenoid adduction (group 2). The need for arytenoid adduction was determined intra-operatively based on subjective voice improvement and laryngoscopic results. Results Arytenoid asymmetry (p < 0.0001), posterior phonatory gap (p = 0.001) and vertical level difference (p = 0.004) were significantly greater in group 2 (descending order of parameters). Arytenoid asymmetry angle showed a significant positive correlation with the latter two parameters. Conclusion Arytenoid asymmetry is the most predictive parameter for arytenoid adduction. An arytenoid asymmetry angle of more than or equal to 33.9⁰ is an indication for arytenoid adduction. This aids in pre-operative planning of arytenoid adduction.

Abductor vocal fold palsy as a manifestation of type one Arnold Chiari malformation

2000 ◽  
Vol 114 (3) ◽  
pp. 221-223 ◽  
Author(s):  
G. M. Allsopp ◽  
A. Karkanevatos ◽  
R. C. Bickerton
Keyword(s):  
Aspiration Pneumonia ◽  
Chiari Malformation ◽  
Vocal Fold ◽  
Rare Case ◽  
Arnold Chiari Malformation ◽  
Vocal Fold Palsy ◽  
Laryngeal Sensation ◽  
Chiari Malformations

We report a rare case of type 1 Chiari malformation which presented to the Otolaryngology department with abductor vocal fold palsy following an aspiration pneumonia secondary to absent laryngeal sensation. Chiari malformations and related cases are discussed.

Laser arytenoidectomy for bilateral vocal fold palsy in Parkinson's disease

2005 ◽  
Vol 119 (10) ◽  
pp. 831-833 ◽  
Author(s):  
A Qayyum ◽  
K Mierzwa ◽  
M See ◽  
A Sharma ◽  
P Q Montgommery
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Option ◽  
Vocal Fold ◽  
English Literature ◽  
Vocal Fold Palsy ◽  
The Individual ◽  
Abductor Palsy

We report a case of laser arytenoidectomy for bilateral abductor palsy of the vocal fold in a patient with Parkinson's disease. Parkinson's disease is known to be a rare cause for bilateral vocal fold palsy and this is the second case reported in the English literature. Majority of the reports to date are in the non-English literature. Tracheostomy has been the classic treatment option offered to these patients. To date no report has been found in the literature about a laser arytenoidectomy being performed in a patient suffering from bilateral vocal fold palsy in Parkinson's disease. We have suggested this option as it improves the quality of life of the individual and avoids the difficulty faced by a Parkinson's patient in managing tracheostomy care due to bradykinesia, rigidity and tremor.

Normalisation of voice parameters in patients with unilateral vocal fold palsy: is it realistic?

2019 ◽  
Vol 133 (12) ◽  
pp. 1097-1102
Author(s):  
R Kumar ◽  
N Banumathy ◽  
P Sharma ◽  
N K Panda
Keyword(s):  
Vocal Fold ◽  
Voice Analysis ◽  
Acoustic Voice Analysis ◽  
Acoustic Measures ◽  
Vocal Fold Palsy ◽  
Males And Females ◽  
Voice Range ◽  
The Voice ◽  
Post Therapy

AbstractBackgroundDisorders of voice can limit an individual's participation and impair social interaction, thus affecting overall quality of life. Perceptual and objective evaluations can provide the clinician with detailed information regarding voice disorders.MethodsThis study comprised 40 subjects aged 34–46 years, 20 of whom (10 male, 10 female) had unilateral vocal fold palsy. Data were obtained for all participants from: the Voice Handicap Index, the grade, roughness, breathiness, asthenia and strain (‘GRBAS’) scale, acoustic voice analysis, electroglottography, and voice range profiles.ResultsThe voice evaluations revealed statistically significant (p < 0.05) differences between the controls and study group, both in males and females, pre- and post-therapy.ConclusionDespite the normalisation of vocal parameters, acoustic, perceptual and self-rated assessments revealed statistically significant differences after therapy. Hence, acoustic measures, namely electroglottographic perturbation, and voice frequency and intensity range, are recommended prior to termination of therapy.

Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis

2010 ◽  
Vol 125 (2) ◽  
pp. 173-180
Author(s):  
J Shi ◽  
S Chen ◽  
D Chen ◽  
W Wang ◽  
S Xia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Patients With Cancer ◽  
Arytenoid Adduction ◽  
Aerodynamic Parameters ◽  
The Impact

AbstractObjectives:(1) To evaluate the efficacy of modified arytenoid adduction in the management of patients with symptomatic cancer-related unilateral vocal fold paralysis, and (2) to assess the impact of this treatment on patients' quality of life.Methods:Forty-two patients with cancer-related unilateral vocal fold paralysis underwent modified arytenoid adduction between February 2001 and December 2008. Of these, 37 patients were enrolled in this retrospective study (one patient died of primary disease and four were lost to follow up). Laryngostroboscopy was performed to evaluate vocal fold orientation and mobility. Pre- and post-operative assessment of subjective and objective voice, aerodynamic parameters, and quality of life were also undertaken, and aspiration was subjectively rated.Results:Laryngostroboscopic findings indicated a significant post-operative improvement in vocal fold posterior glottal closure and vertical gap. Significant improvements in voice quality, aerodynamic parameters and quality of life were noted three months post-operatively in all patients (p < 0.01). The overall success rate for swallowing rehabilitation was 94.6 per cent (35/37). Subjective aspiration ratings decreased significantly post-operatively, compared with pre-operative values (p < 0.01). No major complication occurred in any patient, except for dyspnoea in one patient.Conclusion:Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.

Syringomyelia and bilateral vocal fold palsy

2002 ◽  
Vol 116 (8) ◽  
pp. 633-636 ◽  
Author(s):  
C. Abraham-Igwe ◽  
I. Ahmad ◽  
J. O’Connell ◽  
S. V. Chavda
Keyword(s):  
Emergency Department ◽  
Young Adults ◽  
Vocal Fold ◽  
Chronic Asthma ◽  
Chiari Type ◽  
Chiari Type 1 Malformation ◽  
Accident And Emergency ◽  
Vocal Fold Palsy ◽  
Accident And Emergency Department

This is a case of a 35-year-old who had complained of noisy breathing for 15 years, and had been on treatment for ‘chronic asthma’. She presented to the Accident and Emergency department with an acute episode of difficulty with breathing, and on admission was found to have stridor and bilateral abductor vocal fold palsy. Further workup revealed a syringomyelia with an associated Chiari type 1 malformation. It is important to consider the above diagnosis in the differential of young adults with breathing difficulties. A discussion of syringomyelia, Chiai malformations and bilateral vocal fold palsy follows.

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