Preliminary study of medialization thyroplasty for unilateral vocal fold immobility

Abstract

Objective:To explore the feasibility and effectiveness of medialization thyroplasty for the treatment of unilateral vocal fold immobility （UVFI）. Method:Eight UVFI patients were performed medialization thyroplasty under local anesthesia. We made a window in the thyroid cartilage under local anesthesia, then insert the preformed silicone implant. The paralyzed vocal fold was medialized to make the glottis closed. Fibrolaryngoscope video recording, subjective voice analysis and CT thin slice scan of larynx were done before and after surgery to evaluate closure of vocal cords, improvement of voice and position of implantation. Result:The preoperative and postoperative voice handicap index 30（VHI-30） of the 8 patients were 91.5（64.5, 97.5） and 22.5（5.0, 47.5） respectively, which showed statistical difference（P<0.05）. GRBAS results: The postoperative G, R, B, A were all smaller than preoperative ones, which showed statistical difference（P<0.05）; the pre and postoperative S was both 0. The fibrolaryhgoscope recording showed the preoperative and postoperative score of incomplete glottis closure was 1.0（1.0, 1.0） and 4.0（2.5, 5.0） respectively, which showed statistical difference（P<0.05）. Postoperative laryngeal CT showed significant vocal cord medialization on the affected side. Aspiration was significantly improved in 4 patients who were suffered from this symptom before the surgery. No complication occurred with the 8 patients during 5 to 48 months follow up. Conclusion:Medialization thyroplasty can effectively improve vocalization and quality of life in patients with UVFI.