Functional results of endoscopic arytenoid abduction lateropexy for bilateral vocal fold palsy.

Abstract

PURPOSE:

Endoscopic arytenoid abduction lateropexy (EAAL) is a reliable surgical solution for the minimally invasive treatment of bilateral vocal fold palsy (BVFP), providing a stable airway by the lateralization of the arytenoid cartilages with a simple suture. The nondestructive manner of the intervention theoretically leads to higher regeneration potential, thus better voice quality. The study aimed to investigate the respiratory and phonatory outcomes of this treatment concept.

METHODS:

61 BVFP patients with significant dyspnea associated with thyroid/parathyroid surgery were treated by unilateral EAAL. Jitter, Shimmer, Harmonics to Noise Ratio, Maximum Phonation Time, Fundamental frequency, Voice Handicap Index, Dysphonia Severity Index, Friedrich's Dysphonia Index, Global-Roughness-Breathiness scale, Quality of Life, and Peak Inspiratory Flow were evaluated 18 months after EAAL.

RESULTS:

All patients had a stable and adequate airway during the follow-up. Ten patients (16.4%) experienced complete bilateral motion recovery with objective acoustic parameters in the physiological ranges. Most functional results of the 13 patients (21.3%) with unilateral recovery also reached the normal values. Fifteen patients (24.6%) had unilateral adduction recovery only, with slightly impaired voice quality. Eleven patients (18.0%) had false vocal fold phonation with socially acceptable voice. In 12 patients (19.7%) no significant motion recovery was detected on the glottic level.

CONCLUSION:

EAAL does not interfere with the potential regeneration process and meets the most important phoniatric requirements while guaranteeing the reversibility of the procedure-therefore serving patients with transient palsy. Further, a socially acceptable voice quality and an adequate airway are ensured even in cases of permanent bilateral vocal fold paralysis.

• Authors: László Rovó, Vera Matievics, Balázs Sztanó, László Szakács, Dóra Pálinkó, Christopher T Wootten, Péter Pfiszterer, Zoltán Tóbiás, Ádám Bach
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 279 Issue 4 Pg. 1995-2002 (Apr 2022) ISSN: 1434-4726 [Electronic] Germany
• PMID: 34854971 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).

Topics

• Arytenoid Cartilage (surgery)
• Humans
• Phonation
• Quality of Life
• Treatment Outcome
• Vocal Cord Paralysis
• Vocal Cords (surgery)