• E-ISSN 2583-0104
  • Follow us

International Journal of Preclinical and Clinical Research

Article

International Journal of Preclinical and Clinical Research

Year: 2022, Volume: 3, Issue: 2, Pages: 31-36

Original Article

A Comparative Study on the Outcomes of Early and Delayed Type-1 Thyroplasty Following Unilateral Vocal Cord Palsy

Received Date:06 April 2022, Accepted Date:27 April 2022, Published Date:05 July 2022

Abstract

Unilateral Vocal cord palsy typically presents with dysphonia, shortness of breath and swallowing difficulty. It can be iatrogenic, idiopathic or may occur secondary to damage to recurrent laryngeal nerve following trauma, impinging mass lesions, neurological disorders or neuro-musculoskeletal diseases, or infectious in aetiology. To study and compare the effects of Type I Thyroplasty depending on the time of presentation, that is, early and delayed presentation. Ambispective Study Design. Our study included 32 patients who presented to our Institution with history of dysphonia, diagnosed with unilateral vocal cord palsy. Depending on the duration of symptoms on presentation, patients were categorised into 2 groups, which is early subgroup who presented within 1 year of symptom onset, 21 patients and delayed subgroup who presented after 1 year of symptom onset, 11 patients. Complete preoperative evaluation including perceptual analysis of voice quality, acoustic measures of voice quality, Aerodynamic measures of voice quality, quality of life measure, tele laryngoscopy was done. All patients underwent Type I Thyroplasty and were followed up at 2 weeks, 1 months, 3 months and 6 months, with follow up criteria including perceptual analysis of voice, MPT and VHI-10. Out of 32 patients, Male to female ratio was 26 : 6, with mean age of presentation being 47 years. The laterality of the palsy was R: L → 4: 28. When compared to the Delayed subgroup, early Subgroup had significant improvement in outcomes with respect to GRBAS Scale, VHI-10 and MPT.

 

Keywords: Unilateral vocal cord palsy, Early & Delayed

References

  1. Kwak PE, Tritter AG, Donovan DT, Ongkasuwan J. Long-term Voice Outcomes of Early Thyroplasty for Unilateral Vocal Fold Paralysis Following Aortic Arch SurgeryAnnals of Otology, Rhinology & Laryngology2016;125(7):559563. Available from: https://doi.org/10.1177/0003489416636127
  2. Desuter G, Dedry M, Schaar B, JvLB, Benthem PPv, Sjögren EV. Voice outcome indicators for unilateral vocal fold paralysis surgery: a review of the literatureEuropean Archives of Oto-Rhino-Laryngology2018;275(2):459468. Available from: https://doi.org/10.1007/s00405-017-4844-9
  3. Chowdhury K, Saha S, Saha VP, Pal S, Chatterjee I. Pre and Post Operative Voice Analysis After Medialization Thyroplasty in Cases of Unilateral Vocal Fold ParalysisIndian Journal of Otolaryngology and Head & Neck Surgery2013;65(4):354357. Available from: https://doi.org/10.1007/s12070-013-0649-3
  4. Karine S, Carla AC, Nēdio S, Geraldo PJ, Jéferson B. Voice and vocal fold position in men with unilateral vocal fold paralysisBrazilian Journal of Otorhinolaryngology2011;77(6):761767. Available from: https://pubmed.ncbi.nlm.nih.gov/22183283/
  5. Patel R, Parsram K. Acoustic analysis of subjects with vocal cord paralysisIndian journal of otolaryngology and head and neck surgery2005;57(1):4851. Available from: https://doi.org/10.1007%2FBF02907629
  6. Hartl DM, Hans S, Vaissière J, Riquet M, Brasnu DF. Objective Voice Quality Analysis Before and After Onset of Unilateral Vocal Fold ParalysisJournal of Voice2001;15(3):351361. Available from: https://doi.org/10.1016/s0892-1997(01)00037-6
  7. Tarika B, James LP, DG. Perceptual evaluation of voice quality and its correlation with acoustic measurementsJournal of Voice2004;18(3):299304. Available from: https://doi.org/10.1016/j.jvoice.2003.12.004
  8. Maryn Y, Roy N, Bodt MD, Cauwenberge PV, Corthals P. Acoustic measurement of overall voice quality: A meta-analysisThe Journal of the Acoustical Society of America2009;126(5):26192634. Available from: https://doi.org/10.1121/1.3224706
  9. Se-Jin C, ChoiHong-ShikKim J, Choi YL. Comparison of Maximum Phonation Time Associated with the Changes in Vocal Intensity in Patients with Unilateral Vocal Fold Palsy and Sulcus VocalisJournal of the Korean society of speech sciences2012;4:125131.
  10. Lundy DS, Casiano RR, Xue JW. Can Maximum Phonation Time Predict Voice Outcome after Thyroplasty Type I? The Laryngoscope2004;114(8):14471454. Available from: https://doi.org/10.1097/00005537-200408000-00025
  11. Webb AL, Carding PN, Deary IJ, Mackenzie K, Steen N, Wilson JA. The reliability of three perceptual evaluation scales for dysphoniaEuropean Archives of Oto-Rhino-Laryngology2004;261(8):429434. Available from: https://doi.org/10.1007/s00405-003-0707-7
  12. Renée S, Hans B, Valeria LP, Nel R. Maximum Phonation Time: Variability and ReliabilityJournal of Voice2009;24(3):281285. Available from: https://doi.org/10.1016/j.jvoice.2008.10.004
  13. MPK, Melton SD, Childes JM, Coleman TC, Dailey SA, Hoffman HT. Reliability of Clinician-Based (GRBAS and CAPE-V) and Patient-Based (V-RQOL and IPVI) Documentation of Voice DisordersJournal of Voice2007;21(5):576590. Available from: https://doi.org/10.1016/j.jvoice.2006.05.001
  14. Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and Validation of the Voice Handicap Index-10The Laryngoscope2004;114(9):15491556. Available from: https://doi.org/10.1097/00005537-200409000-00009
  15. Ryu IS, Nam SY, Han MW, Choi SH, Kim SY, Roh JL. Long-term Voice Outcomes After Thyroplasty for Unilateral Vocal Fold ParalysisArch Otolaryngol Head Neck Surg2012;138(4):347351. Available from: https://doi.org/10.1001/archoto.2012.42
  16. Ali I, Khalid F, Shafi OM, Makhdoomi O. Voice outcome after type-1 thyroplasty for unilateral vocal cord paralysis: our experience at tertiary care hospitalInternational Journal of Otorhinolaryngology and Head and Neck Surgery2020;6(8):1449. Available from: https://dx.doi.org/10.18203/issn.2454-5929.ijohns20203193
  17. Isshiki N. Vocal mechanics as the basis for phonosurgeryThe Laryngoscope1998;108(12):17611766. Available from: https://doi.org/10.1097/00005537-199812000-00001
  18. Isshiki N, Morita H, Okamura H, Hiramoto M. Thyroplasty as a New Phonosurgical TechniqueActa Oto-Laryngologica1974;78(1-6):451457. Available from: https://doi.org/10.3109/00016487409126379
  19. Harries ML. Laryngeal framework surgery (thyroplasty) The Journal of Laryngology & Otology1997;111(2):103105.
  20. Pal KS, Kaushal AK, Nagpure PS, Agarwal G. Etiopathological Study of 100 Patients of Hoarseness of Voice: In a Rural Based HospitalIndian Journal of Otolaryngology and Head & Neck Surgery2014;66(1):4045. Available from: https://doi.org/10.1007%2Fs12070-013-0660-8
  21. Baitha S, Raizada RM, Singh AKK, Puttewar MP, Chaturvedi VN. Clinical profile of hoarseness of voiceIndian Journal of Otolaryngology and Head and Neck Surgery2002;54(1):1418. Available from: https://doi.org/10.1007%2FBF02910998
  22. Crumley RL. Unilateral recurrent laryngeal nerve paralysisJournal of Voice1994;8(1):7983. Available from: https://doi.org/10.1016/s0892-1997(05)80323-6
  23. Friedman AD, Burns JA, Heaton JT, Zeitels SM. Early versus late injection medialization for unilateral vocal cord paralysisThe Laryngoscope120(10):20422046. Available from: https://doi.org/10.1002/lary.21097

Copyright

© 2022 Prahlada & Raisa. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Published By Basaveshwara Medical College & Hospital, Chitradurga, Karnataka.

DON'T MISS OUT!

Subscribe now for latest articles and news.