Medialization Laryngoplasty: A Review for Speech-Language Pathologists

Purpose The purpose of this study is to familiarize speech-language-pathologists with the current state of the science regarding medialization laryngoplasty in the treatment of voice disorders, with emphasis on current evidence-based practice, voice outcomes, and future directions for research. Method A literature review was performed in PubMed and Embase using the keywords vocal fold/cord and laryngoplasty, thyroplasty, augmentation, or laryngeal framework . Articles published between 2010 and 2020 were reviewed for data about clinical applications, technical approach, voice-related outcomes, and basic science or clinical innovations with the potential to improve patient care. A synthesis of data was performed from articles meeting the outlined search criteria. Conclusions As key members in the multidisciplinary care of voice disorders, speech-language pathologists need to be informed of current research in medialization laryngoplasty, a procedure commonly used for patients with glottic insufficiency. Advances in anesthetic technique, office-based procedures, and the development of materials with increased bio-tolerability over the past decade have led to innovations in treatment and improved patient outcomes. Recent applications of computational and bioengineering approaches have the potential to provide new directions in the refinement of currently available techniques and the improvement of patient-based treatment outcomes.

Patient-Related Factors of Medialization Laryngoplasty with Autologous Thyroid Cartilage

(1) Background: Medialization laryngoplasty with autologous thyroid cartilage (MLATC) is a surgical treatment for glottal closure insufficiency (GCI) resulted from unilateral vocal fold paralysis/paresis (UVFP) and vocal fold atrophy. We aimed to survey the influence of patient-related factors on the outcomes after MLATC. (2) Methods: The study enrolled 35 patients with GCI who underwent MLATC. Patient voice data were recorded before and after MLATC by using multiple acoustic parameters and subjective assessment in a computerized speech laboratory. GCI patients were characterized into subgroups based on three factors: age, ≥60 vs. <60 years; sex, men vs. women; and BMI, ≥24 vs. <24. (3) Results: When the subgroups were compared, men did not have better results after surgery than women. Patients ages < 60 years did not exhibit any significantly different outcome compared with those aged ≥ 60 years. Patients with BMI ≥ 24 did not have any significantly different outcome compared with those with BMI < 24. The subgroups of age, sex, and BMI had no significant difference in cumulative voice recovery and summation of GRBAS (G = grade, R = roughness, B = breathiness, A = asthenia, and S = strain). (4) Conclusions: MLATC is a good alternative surgery with long-term improvement in GCI patients. There is no evidence that age, sex, or BMI affect the functional outcome.

A study of phonosurgeries in vocal dysfunction in Salem district

<p class="abstract"><strong>Background: </strong>Phonosurgery essentially is surgery defined to improve or restore the voice. The objective of the study was to analyze and categorize the various benign lesions of the vocal cord causing vocal dysfunction requiring phonosurgeries, to analyze the incidence and distribution of cases according to age, sex, and etiology among the patients who require intense medical and voice therapy with surgical intervention.<strong> </strong></p><p class="abstract"><strong>Methods: </strong>This prospective study was conducted in fifty patients with vocal dysfunction from the ear, neck and throat (ENT) outpatient department of Otorhinolaryngology, Mohan Kumaramangalam Government General Hospital, Salem in the year September 2018 to October 2019 who failed conservative medical and voice therapy requiring phonological procedure were included in this study. Phonomicrosurgery was done for the patients with benign vocal fold mucosal disorders and medialization laryngoplasty using Gore-Tex was done for the patients with unilateral vocal cord palsy causing vocal dysfunction.</p><p class="abstract"><strong>Results: </strong>The present study on phono surgery concludes vocal polyp is the commonest benign lesion of the vocal cord that constitutes 40% in our study population. Males are affected more than females. Proper investigation of voice and larynx provides the exact pathological nature of the lesion and determines the timing of surgical intervention.<strong></strong></p><p class="abstract"><strong>Conclusion: </strong>Most of the patients who underwent medialization laryngoplasty using Gore-Tex also had a good outcome at the end of the voice therapy.</p><p> </p>