Abstract
(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.
Highlights
Glottal closure insufficiency (GCI) is a common cause of voice disorders and results from the uncompleted closure of the vocal folds [1,2] due to mucosal lesions or vocal mobility [3]
Between August 2012 and March 2019, we performed a retrospective cohort study and evaluated 35 patients newly diagnosed as having glottal closure insufficiency (GCI) who received Isshiki type I thyroplasty with autologous thyroid cartilage implants at the Department of Otorhinolaryngology, Chiayi Chang Gung
medialization laryngoplasty through autologous thyroid cartilage (MLATC) is a suitable option for patients with GCI who prefer not to undergo injection laryngoplasty with temporal effects
Summary
Glottal closure insufficiency (GCI) is a common cause of voice disorders and results from the uncompleted closure of the vocal folds [1,2] due to mucosal lesions or vocal mobility [3]. Medialization laryngoplasty (ML), when an implant is inserted through a lateral window in the thyroid cartilage to medialize the vocal folds, is an effective surgical procedure for treating glottal insufficiency, and a Montgomery thyroplasty Implant System with a Silastic block has been developed to treat unilateral vocal fold paralysis through medialization of the paralyzed cord [11]. As demonstrated in our previous study, modified medialization laryngoplasty through autologous thyroid cartilage (MLATC) is a practical surgical treatment for UVFP [2,12], which can reduce the glottal gap, medialize the vocal fold, and mitigate
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