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Hemi-laryngeal Setup for Studying Vocal Fold Vibration in Three Dimensions
Published on: November 25, 2017
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Fenestration Approach for Arytenoid Adduction in Unilateral Vocal Fold Paralysis
Ray Motohashi1, Ryoji Tokashiki2, Eriko Sakurai1
1Department of Otorhinolaryngology, Head and Neck Surgery, Tokyo Medical University, Tokyo, Japan.
Summary
This study shows that combining arytenoid adduction (AA) with type I thyroplasty (TPI) using a fenestration approach significantly improves voice outcomes for unilateral vocal fold paralysis (UVFP) patients.
Area of Science:
- Otolaryngology
- Speech and Voice Science
Background:
- Unilateral vocal fold paralysis (UVFP) presents significant voice challenges.
- Various surgical techniques exist, but long-term data on the fenestration approach for arytenoid adduction (AA) are limited.
Purpose of the Study:
- To evaluate the long-term voice outcomes of AA combined with type I thyroplasty (TPI) using a fenestration approach in UVFP patients.
Main Methods:
- Retrospective study of 168 UVFP patients undergoing AA and TPI via fenestration.
- Measurements included maximum phonation time (MPT), mean airflow rate (MFR), jitter, and shimmer before and after surgery.
- 3D CT data guided the creation of anterior and posterior surgical windows in the thyroid ala.
Main Results:
- 156 of 168 patients achieved MPT >10 seconds postoperatively.
- Significant improvements were observed in MPT, MFR, jitter, and shimmer for all patients.
- Perceptual evaluation (GRBAS scale) indicated significant voice quality improvement.
Conclusions:
- The fenestration approach for AA and TPI preserves laryngeal joint integrity, stabilizing the framework.
- This technique offers stable, long-term voice improvement for patients with UVFP.
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