| Multiparameter comparison of injection laryngoplasty, medialization laryngoplasty, and arytenoid adduction in an excised larynx model. | |
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MedLine Citation:
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PMID: 20213797 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Matthew R Hoffman; Rachel E Witt; William J Chapin; Timothy M McCulloch; Jack J Jiang |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: The Laryngoscope Volume: 120 ISSN: 1531-4995 ISO Abbreviation: Laryngoscope Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-29 Completed Date: 2010-05-25 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 769-76 Citation Subset: IM |
Affiliation:
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Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Arytenoid Cartilage / physiopathology, surgery* Disease Models, Animal Dogs Injections Laryngeal Mucosa / drug effects Larynx / surgery* Phonation / physiology* Reconstructive Surgical Procedures / methods* Vocal Cord Paralysis / physiopathology, rehabilitation, surgery* |
| Grant Support | |
ID/Acronym/Agency:
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R01 DC005522-11/DC/NIDCD NIH HHS; R01 DC008153/DC/NIDCD NIH HHS; R01 DC008153-03/DC/NIDCD NIH HHS; R01 DC008153-05/DC/NIDCD NIH HHS; R01 DC008850/DC/NIDCD NIH HHS; R01 DC008850-04/DC/NIDCD NIH HHS; R01 DC05522/DC/NIDCD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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