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Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis

Published online by Cambridge University Press:  25 November 2010

J Shi ,
S Chen ,
D Chen ,
W Wang ,
S Xia  and
H Zheng
J Shi
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
S Chen
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
D Chen
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
W Wang
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
S Xia
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
H Zheng*
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
*
Address for correspondence: Dr Hongliang Zheng, Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Changhai Road 168, Shanghai 200433, China Fax: +86 21 65335025 E-mail: [email protected]
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Abstract

Objectives:

(1) To evaluate the efficacy of modified arytenoid adduction in the management of patients with symptomatic cancer-related unilateral vocal fold paralysis, and (2) to assess the impact of this treatment on patients' quality of life.

Methods:

Forty-two patients with cancer-related unilateral vocal fold paralysis underwent modified arytenoid adduction between February 2001 and December 2008. Of these, 37 patients were enrolled in this retrospective study (one patient died of primary disease and four were lost to follow up). Laryngostroboscopy was performed to evaluate vocal fold orientation and mobility. Pre- and post-operative assessment of subjective and objective voice, aerodynamic parameters, and quality of life were also undertaken, and aspiration was subjectively rated.

Results:

Laryngostroboscopic findings indicated a significant post-operative improvement in vocal fold posterior glottal closure and vertical gap. Significant improvements in voice quality, aerodynamic parameters and quality of life were noted three months post-operatively in all patients (p < 0.01). The overall success rate for swallowing rehabilitation was 94.6 per cent (35/37). Subjective aspiration ratings decreased significantly post-operatively, compared with pre-operative values (p < 0.01). No major complication occurred in any patient, except for dyspnoea in one patient.

Conclusion:

Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.

Keywords

Vocal Fold ParalysisHead and Neck NeoplasmsSurgeryQuality of Life
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 2 , February 2011 , pp. 173 - 180
Copyright
Copyright © JLO (1984) Limited 2010

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References

1Abraham, MT, Gonen, M, Kraus, DH. Complications of type I thyroplasty and arytenoid adduction. Laryngoscope 2001;111:1322–9CrossRefGoogle ScholarPubMed
2Hong, KH, Jung, KS. Arytenoid appearance and vertical level difference between the paralyzed and innervated vocal cords. Laryngoscope 2001;112:227–32CrossRefGoogle Scholar
3Su, CY, Tsai, SS, Chuang, HC, Chiu, JF. Functional significance of arytenoid adduction with the suture attaching to cricoid cartilage versus to thyroid cartilage for unilateral paralytic dysphonia. Laryngoscope 2005;115:1752–9CrossRefGoogle ScholarPubMed
4Isshiki, N, Tanabe, M, Sawada, M. Arytenoid adduction for unilateral vocal cord paralysis. Arch Otolaryngol 1978;104:555–8CrossRefGoogle ScholarPubMed
5Hoffman, HT, McCulloch, TM. Anatomic considerations in the surgical treatment of unilateral laryngeal paralysis. Head Neck 1996;18:174–73.0.CO;2-F>CrossRefGoogle ScholarPubMed
6Sonoda, S, Kataoka, H, Inoue, T. Traction of lateral cricoarytenoid muscle for unilateral vocal fold paralysis: comparison with Issiki's original technique of arytenoid adduction. Ann Otol Rhinol Laryngol 2005;114:132–8CrossRefGoogle Scholar
7Spector, BC, Netterville, JL, Billante, C, Clary, J, Reinisch, L, Smith, TL. Quality-of-life assessment in patients with unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 2001;125:176–82CrossRefGoogle ScholarPubMed
8Woodson, GE, Picerno, R, Yeung, D, Hengesteg, A. Arytenoid adduction: controlling vertical position. Ann Otol Rhinol Laryngol 2000;109:360–4CrossRefGoogle ScholarPubMed
9Cummings, CW, Purcell, LL, Flint, PW. Hydroxylapatite laryngeal implants for medialization: preliminary report. Ann Otol Rhinol Laryngol 1993;102:843–51CrossRefGoogle ScholarPubMed
10Hirano, M. Psycho-acoustic Evaluation of Voice: GRBAS Scale for Evaluating the Hoarse Voice. Clinical Examination of Voice. New York: Springer-Verlag, 1981Google Scholar
11Zheng, H, Li, Z, Zhou, S, Cuan, Y, Wen, W. Update: laryngeal reinnervation for unilateral vocal cord paralysis with the ansa cervicalis. Laryngoscope 1996;106:1522–7CrossRefGoogle ScholarPubMed
12Billante, CR, Spector, B, Hudson, M, Burkard, K, Netterville, JL. Voice outcome following thyroplasty in patients with cancer-related vocal fold paralysis. Auris Nasus Larynx 2001;28:315–21CrossRefGoogle ScholarPubMed
13Ware, JE Jr, Sherbourne, CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992;30:473–83CrossRefGoogle ScholarPubMed
14McHorney, CA, Ware, JE, Racezk, AE. The MOS 36-item shortform health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247–63CrossRefGoogle ScholarPubMed
15Jacobson, BH, Johnson, A, Grywalsky, C, Silbergleit, A, Jacobson, G, Benninger, MS et al. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66–70CrossRefGoogle Scholar
16Gliklich, RE, Glovsky, RM, Montgomery, WM. Validation of a voice outcome survey for unilateral vocal cord paralysis. Otolaryngol-Head Neck Surg 1999;120:153–8Google ScholarPubMed
17Ware, JE, Snow, KK, Kosinski, M, Gandek, B. SF-36 Health Survey Manual and Interpretation Guide. Boston: New England Medical Center, The Health Institute, 1993Google Scholar
18Chhetri, DK, Gerratt, BR, Kreiman, J, Berke, GS. Combined arytenoid adduction and laryngeal reinnervation in the treatment of vocal cord paralysis. Laryngoscope 1999;109:1928–36CrossRefGoogle Scholar
19Zheng, H, Li, Z, Zhou, S, Cuan, Y, Wen, W, Lan, J. Experimental study on reinnervation of vocal cord adductors with the ansa cervicalis. Laryngoscope 1996;106:1516–21CrossRefGoogle Scholar
20Zheng, H, Zhou, S, Chen, S, Li, Z, Cuan, Y. An experimental comparison of different kinds of laryngeal muscle reinnervation. Otolaryngol Head Neck Surg 1998;119:540–7Google ScholarPubMed
21Su, CY, Lui, CC, Lin, HC, Chiu, JF, Cheng, CA. A new paramedian approach to arytenoid adduction and strap muscle transposition for vocal cord medialization. Laryngoscope 2002;112:342–50CrossRefGoogle Scholar
22Tucker, HM, Wanamaker, J, Trott, M, Hicks, D. Complications of laryngeal framework surgery (phonosurgery). Laryngoscope 1993;103:525–8CrossRefGoogle ScholarPubMed