Comparison of Vocal Outcome after Autologous Fat Injection and Medialization Thyroplasty for Unilateral Vocal Cord Paralysis

2010 ◽  
Vol 53 (1) ◽  
pp. 24 ◽  
Author(s):  
Sung-Hyen Bae ◽  
Sang Joon Lee
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Fat Injection ◽  
Autologous Fat ◽  
Medialization Thyroplasty ◽  
Vocal Outcome ◽  
Unilateral Vocal Cord Paralysis

S183 – Intracordal Fat Assessment after Injection Laryngoplasty

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P137-P137
Author(s):  
Tuan-Jen Fang ◽  
Chao-Jan Wang ◽  
Hsueh-Yu Li
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Upper Airway ◽  
Fat Injection ◽  
Long Term Outcomes ◽  
Autologous Fat ◽  
The Mean ◽  
Fat Volume ◽  
Unilateral Vocal Cord Paralysis

Objectives Autologous fat injection for unilateral vocal cord paralysis is a popular procedure for immediate symptoms control, but uneven long-term outcomes were reported. Most authors believed that the continual resorption of injected fat was the cause of voice degradation. A long-term residual fat volume was evaluated. Methods We retrospectively reviewed the patients following autologous fat injection for symptomatic unilateral vocal cord paralysis from 2002 Aug to 2006 July. The patients accepted head and neck computed tomogragphy (CT) evaluation following surgery were included. A three-dimensional reconstruction of the images of larynx and upper airway was performed on the work station (Vitrea® 2, version 3.9). The volume of intracordal fat was then calculated. Results 5 males and 15 females of the mean age 49 were enrolled. The mean duration from lipoinjection surgery to the CT study is 23.0 months (12–50 months). The injection fat was found in all study cases. The estimated fat volume ranged from 0.01 to 0.75 ml with a mean 0.33 ml. Compare with the injected fat volume, a mean 27.5% fat survived. The correlation between residual fat volume rate and duration of follow-up is not significant. Conclusions The intracordal fat volume didn't decline from time. Long-term intracordal injected fat diminished but survived in all cases. The degradation may be caused by absorption or immediate extrusion from injection wound. An over-correction and prevention of extrusion postoperatively would improve the long-term outcomes.

scholarly journals Glottal Function Index and GRBAS Scale of Patients Undergoing Vocal Cord Medialization: A Series of Five Patients

2013 ◽  
Vol 28 (2) ◽  
pp. 14-17
Author(s):  
Enrique C. Papa ◽  
Emmanuel S. Samson ◽  
Francisco A. Victoria
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Voice Quality ◽  
Silicone Implant ◽  
Subjective Symptoms ◽  
Medialization Thyroplasty ◽  
Function Index ◽  
Glottal Insufficiency ◽  
Unilateral Vocal Cord Paralysis

Objectives: Vocal cord paralysis or immobility is a debilitating condition that may result from neural injury or mechanical fixation of the vocal cord (VC).  When permanent, therapy is aimed at improving closure by modifying the position of the vocal cord. Whatever surgical intervention is chosen, pre - and post - operative voice evaluation is important. This study aimed to investigate the usefulness of the Glottal Function Index (GFI) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) Scale in the evaluation of treatment outcomes in patients with unilateral vocal cord paralysis (UVCP) who underwent medialization thyroplasty type 1 with a modified lock-in soft silicone implant. Methods: Study Design: Descriptive Case Series Setting: Tertiary Government Hospital Patients: Five Results:  Five patients (3 females, 2 males) consulting due to hoarseness underwent rigid endoscopy.  Four (2 right, 2 left) had unilateral paramedian VC paralysis while one had bilateral paresis with bowing of the left vocal cord.  One of those with left VC paralysis was diagnosed as idiopathic; the four were iatrogenic (3 from thyroid surgery, 1 from multiple surgical procedures). All patients underwent medialization thyroplasty type 1 using locked-in soft silicone implant. The GFI and GRBAS scale were utilized for pre-operative and post-operative perceptual evaluation of voice.  The GFI showed severe glottic insufficiency among all five patients prior to surgery with improvement of subjective symptoms one day and one week post-surgery in four patients. Likewise, the Hirano GRBAS scale showed improvement of voice quality and correlated well with the improvement of the patient’s subjective symptoms from the GFI scores. However, case 5 with bilateral vocal cord paresis, showed no improvement of voice quality despite recovery from subjective symptoms. Conclusion: For glottal insufficiency, perceptual voice evaluation using self-administered GFI and GRBAS scale assessment are important parameters in determining quality of life among patients with glottal insufficiency undergoing medialization laryngoplasty. Keywords: Hoarseness, unilateral vocal cord paralysis, medialization thyroplasty, Glottal Function Index, Hirano GRBAS Score

Pre- and post-operative high-speed videolaryngoscopy in unilateral vocal cord paralysis following autologous fat augmentation

2021 ◽  
Vol 42 (2) ◽  
pp. 102878
Author(s):  
Sachin Gandhi ◽  
Subash Bhatta ◽  
Dushyanth Ganesuni ◽  
Asheesh Dora Ghanpur ◽  
Shraddha Jayant Saindani
Keyword(s):  
Vocal Cord ◽  
High Speed ◽  
Vocal Cord Paralysis ◽  
Autologous Fat ◽  
Unilateral Vocal Cord Paralysis

scholarly journals Outcomes of Fat Injection Laryngoplasty in Unilateral Vocal Cord Paralysis

2010 ◽  
Vol 136 (5) ◽  
pp. 457 ◽  
Author(s):  
Tuan-Jen Fang ◽  
Hsueh-Yu Li ◽  
Richard E. Gliklich ◽  
Ya-Hui Chen ◽  
Pa-Chun Wang ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Injection Laryngoplasty ◽  
Fat Injection ◽  
Unilateral Vocal Cord Paralysis

Precise Vocal Cord Medialization Using an Adjustable Laryngeal Implant: A Preliminary Study

1993 ◽  
Vol 109 (6) ◽  
pp. 1014-1019 ◽  
Author(s):  
Martin Desrosiers ◽  
Christian Ahmarani ◽  
Maurice Bettez
Keyword(s):  
Vocal Cord ◽  
Vocal Fold ◽  
Vocal Cord Paralysis ◽  
Substantial Improvement ◽  
Vocal Function ◽  
Medialization Thyroplasty ◽  
Preliminary Study ◽  
Vocal Quality ◽  
Unilateral Vocal Cord Paralysis

Treatment of symptomatic unilateral vocal cord paralysis is most frequently surgical. Medialization of the vocal cord using Teflon injection has proved effective; however, studies have shown this technique to produce stiffness of the vocal fold with loss of the “mucosal wave” and concomitantly poor vocal function. As well, overcorrection may occur and is not reversible. Isshiki type 1 medialization thyroplasty has been shown to produce a substantial improvement In vocal quality, as well as preserve the mucosal wave. A number of problems encountered during the performance of isshiki type 1 thyroplasty has led us to modify the original technique. We have developed a new implant that allows for precise, easily adjustable control of vocal cord medialization. To evaluate the degree of vocal cord medialization afforded by this implant, larynges of fresh male and female cadavers were used as an experimental model. In both larynges, vocal cord medialization was shown to occur in a predictable fashion for the anterior, middle, and posterior segments, as well as In the functionally Important inter-arytenoid region. We believe the use of this implant in medialization thyroplasty will allow precise, atraumatic medialization of the paralyzed vocal cord. This greater control over positioning and ease of adjustment should contribute to enhanced vocal quality.

scholarly journals Gore-Tex Medialization Thyroplasty in Patients with Unilateral Vocal Cord Paralysis: An Audit of 47 Cases

2011 ◽  
Vol 1 (1) ◽  
pp. 11-13 ◽  
Author(s):  
M Gopinath ◽  
Mukundan Subramanian
Keyword(s):  
Surgical Technique ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Medialization Thyroplasty ◽  
Implant Material ◽  
Unilateral Vocal Cord Paralysis ◽  
The Ideal

ABSTRACT Though the surgical technique of medialization thyroplasty has been standardized, still the ideal implant has not been defined in the management of unilateral vocal cord paralysis. The authors present their experience of Gore-tex as the implant material.

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