Medialization framework surgery for voice improvement after endoscopic cordectomy.

Area of Science:

• Otolaryngology
• Laryngology
• Speech Science

Background:

• Total or extended cordectomy can lead to significant voice impairment.
• Reconstructive surgery is often necessary to restore vocal function after cordectomy.
• Laryngeal framework medialization aims to improve voice quality by repositioning vocal cord structures.

Purpose of the Study:

• To evaluate the efficacy of laryngeal framework medialization in patients with dysphonia after cordectomy.
• To assess objective voice parameters and subjective patient-reported outcomes following the procedure.
• To determine the suitability of specific implants, like Friedrich's implant, for different vocal cord gap sizes.

Main Methods:

• Seven dysphonic patients underwent laryngeal framework medialization after a minimum 6-month recovery period post-cordectomy.
• The surgery was performed under general anesthesia with fiberscopic control.
• Friedrich's implant was advocated for wider vocal cord gaps, while cartilage implants were considered for minor gaps.

Main Results:

• Median maximum phonation time increased from 5s to 7.5s.
• Phonation quotient decreased significantly, indicating improved vocal fold closure.
• Patients reported reduced phonation effort and vocal fatigue, with improved intensity range and spectral analysis class.

Conclusions:

• Laryngeal framework medialization, particularly with Friedrich's implant for wider gaps, is an effective treatment for voice restoration after cordectomy.
• The procedure leads to measurable improvements in objective voice parameters and significant subjective benefits for patients.
• A waiting period post-cordectomy allows for natural scar formation and assessment of speech therapy outcomes before surgical intervention.