Airway flow dynamics and voice acoustics after autologous fascia augmentation of paralyzed vocal fold.

Abstract

The aim of this study was to assess the effect of vocal fold medialization, accomplished by injection of autologous fascia, on airflow dynamics and voice acoustics. Ten patients with unilateral vocal fold paralysis were included. Flow-volume spirometry, body plethysmography, and acoustic analysis of voice were performed within 1 week before injection of autologous fascia and 4 to 14 months after operation. Medialization of the paralyzed vocal fold decreased the mean peak inspiratory flow (PIF) from 4.63 L to 4.10 L (p = .012). The acoustic characteristics of the voice improved: the values of jitter, shimmer, and mean noise-to-harmonics ratio decreased significantly (p = .006, p = .017, and p = .047, respectively), and the mean maximal phonation time almost doubled (p = .002). Changes in PIF and shimmer showed a negative correlation (r = -.857, p = .007). In conclusion, injection of autologous fascia improves voice acoustics, but induces a slight abnormal limitation on PIF. The results also suggest that improvement in voice acoustics is most prominent in subjects with the least deterioration in inspiratory airflow.