Journal article
Multiparameter comparison of injection laryngoplasty, medialization laryngoplasty, and arytenoid adduction in an excised larynx model
The Laryngoscope, Vol.120(4), pp.769-776
04/2010
DOI: 10.1002/lary.20830
PMCID: PMC2954108
PMID: 20213797
Abstract
Objectives/Hypothesis: Evaluate the effect of injection laryngoplasty (IL), medialization laryngoplasty (ML), and ML combined with arytenoid adduction (ML-AA) on acoustic, aerodynamic, and mucosal wave measurements in an excised larynx setup. Study Design: Comparative case study using ex vivo canine larynges. Methods: Measurements were recorded for eight excised canine larynges with simulated unilateral vocal fold paralysis before and after vocal fold injection with Cymetra. A second set of eight larynges was used to evaluate medialization laryngoplasty using a Silastic implant without and with arytenoid adduction. Results: IL and ML led to comparable decreases in phonation threshold flow (PTF), phonation threshold pressure (PTP), and phonation threshold power (PTW). ML-AA led to significant decreases in PTF (P = .008), PTP (P = .008), and PTW (P = .008). IL and ML led to approximately equal decreases in percent jitter and percent shimmer. ML-AA caused the greatest increase in signal-to-noise ratio. ML-AA discernibly decreased frequency (P = 0.059); a clear trend was not observed for IL or ML. IL significantly reduced mucosal wave amplitude (P = 0.002), whereas both ML and ML-AA increased it. All procedures significantly decreased glottal gap, with the most dramatic effects observed after ML-AA (P = 0.004). Conclusions: ML-AA led to the greatest improvements in phonatory parameters. IL was comparable to ML aerodynamically and acoustically, but caused detrimental changes to the mucosal wave. Incremental improvements in parameters recorded from the same larynx were observed after ML and ML-AA. To ensure optimal acoustic outcome, the arytenoid must be correctly rotated. This study provides objective support for the combined ML-AA procedure in tolerant patients. © 2010 The American Laryngological, Rhinological and Otological Society, Inc.
Details
- Title: Subtitle
- Multiparameter comparison of injection laryngoplasty, medialization laryngoplasty, and arytenoid adduction in an excised larynx model
- Creators
- Matthew R. Hoffman - University of Wisconsin–MadisonRachel E. Witt - University of Wisconsin–MadisonWilliam J. Chapin - University of Wisconsin–MadisonTimothy M. McCulloch - University of Wisconsin–MadisonJack J. Jiang - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.120(4), pp.769-776
- DOI
- 10.1002/lary.20830
- PMID
- 20213797
- PMCID
- PMC2954108
- NLM abbreviation
- Laryngoscope
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Publisher
- Wiley Subscription Services, Inc., A Wiley Company
- Number of pages
- 8
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: R01 DC008153, R01 DC05522, R01 DC008850; DOI: 10.13039/100000055, name: National Institute on Deafness and Other Communicative Disorders
- Language
- English
- Date published
- 04/2010
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984366376502771
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