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  • Title: Long-term voice outcomes after thyroplasty for unilateral vocal fold paralysis.
    Author: Ryu IS, Nam SY, Han MW, Choi SH, Kim SY, Roh JL.
    Journal: Arch Otolaryngol Head Neck Surg; 2012 Apr; 138(4):347-51. PubMed ID: 22431862.
    Abstract:
    OBJECTIVES: To investigate the long-term clinical efficacy and stability of thyroplasty type I for unilateral vocal cord palsy, and to identify the appropriate timing of posttreatment evaluations for determination of long-term voice outcome. Study DESIGN: Single-institution retrospective study. SETTING: Academic tertiary referral centers in Korea. PATIENTS: Forty patients with unilateral vocal cord palsy who underwent thyroplasty from January 1, 1996, through December 31, 2006, and were followed up for at least 5 years after the surgical procedure. INTERVENTIONS: Thyroplasty type I under local anesthesia. MAIN OUTCOME MEASURES: Acoustic and aerodynamic analyses of voice were performed on the day before the operation and at preset intervals afterward. Two blinded speech-language pathologists performed the perceptual evaluation. RESULTS: The GRBAS scale (grade of hoarseness, roughness, breathiness, asthenia, and strain) values showed significant improvement at 6 months after the operation (P < .05); these improvements continued up to 1 year and were maintained 5 years after the operation. Acoustic measurements of shimmer and jitter began to show significant improvement at 6 months after the operation, and fundamental frequency and noise harmonic ratios evidenced significant improvement at 1 year (P < .05); these improvements were maintained, to a significant extent, at 5 years after the operation. Aerodynamically, the maximum phonation time, glottal flow rate, and peak subglottic pressure improved significantly from before the operation to 6 months and 1 year after the operation, attaining near-normal values at 1 year afterward (P < . 05) CONCLUSIONS: Thyroplasty type I may provide evidence that voice outcome progressively evolves during the first years after the surgical procedure, and that subsequent vocal improvement presented long-lasting stabilization. To assess the long-term voice quality, it may be enough to perform the voice evaluation at 1 year after the procedure.
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