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Phonosurgical methods of treatment in unilateral vocal folds paralysis.

Abstract Glottal insufficiency (GI) is a cause of breathy voice that can profoundly affect quality of voice. Main causes are unilateral vocal fold paralysis or endoscopic cordectomy for the early treatment of laryngeal cancer of the glottis. The main strategy in surgical treatment is type I medialization thyroplasty according to Isshiki with the use of implants e.g. silastic, hydroxyapatite, titanium, Gore-Tex or Montgomery. Other procedures are arytenoid adduction, the injection laryngoplasty via thyrohyoid and cricothyroid approach and laryngeal reinnervation. To predict successful voice outcome and to prevent revision surgery, surgeon must choose appropriate size of the implant on the basis of subjective intraoperative visualization of the glottal closure during phonation in fibroptic laryngoscopy and by objective measurement of peroperative maximal phonation time (MPT) or direct peak subglottic pressure (DPSP) through a catheter inserted into the cricothyroid membrane. Majority of otolaryngologist recommend surgical treatment 12 months after the onset of unilateral vocal fold paralysis, before performing any permanent intervention, because some patients will have full or partial recovery of the recurrent laryngeal nerve (RLN) function and others will have adequate compensation from the intact side.
PMID
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Authors

Mayor MeshTerms

Laryngoplasty

Keywords

maximum phonation time

medialization thyreoplasty

recurrent laryngeal nerve

subglottic pressure

vocal fold

Journal Title polski merkuriusz lekarski : organ polskiego towarzystwa lekarskiego
Publication Year Start




PMID- 28530217
OWN - NLM
STAT- MEDLINE
DA  - 20170522
DCOM- 20170707
LR  - 20170707
IS  - 1426-9686 (Print)
IS  - 1426-9686 (Linking)
VI  - 42
IP  - 250
DP  - 2017 Apr 21
TI  - [Phonosurgical methods of treatment in unilateral vocal folds paralysis].
PG  - 173-177
AB  - Glottal insufficiency (GI) is a cause of breathy voice that can profoundly affect
      quality of voice. Main causes are unilateral vocal fold paralysis or endoscopic
      cordectomy for the early treatment of laryngeal cancer of the glottis. The main
      strategy in surgical treatment is type I medialization thyroplasty according to
      Isshiki with the use of implants e.g. silastic, hydroxyapatite, titanium,
      Gore-Tex or Montgomery. Other procedures are arytenoid adduction, the injection
      laryngoplasty via thyrohyoid and cricothyroid approach and laryngeal
      reinnervation. To predict successful voice outcome and to prevent revision
      surgery, surgeon must choose appropriate size of the implant on the basis of
      subjective intraoperative visualization of the glottal closure during phonation
      in fibroptic laryngoscopy and by objective measurement of peroperative maximal
      phonation time (MPT) or direct peak subglottic pressure (DPSP) through a catheter
      inserted into the cricothyroid membrane. Majority of otolaryngologist recommend
      surgical treatment 12 months after the onset of unilateral vocal fold paralysis, 
      before performing any permanent intervention, because some patients will have
      full or partial recovery of the recurrent laryngeal nerve (RLN) function and
      others will have adequate compensation from the intact side.
FAU - Kosztyla-Hojna, Bozena
AU  - Kosztyla-Hojna B
AD  - Department of Clinical Phonoaudiology and Logopedics, Medical University of
      Bialystok, Poland.
FAU - Berger, Greta
AU  - Berger G
AD  - Department of Clinical Phonoaudiology and Logopedics, Medical University of
      Bialystok, Poland.
FAU - Zdrojkowski, Maciej
AU  - Zdrojkowski M
AD  - Department of Clinical Phonoaudiology and Logopedics, Medical University of
      Bialystok, Poland.
LA  - pol
PT  - Journal Article
PT  - Review
TT  - Fonochirurgiczne metody leczenia jednostronnych porazen faldow glosowych.
PL  - Poland
TA  - Pol Merkur Lekarski
JT  - Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego
JID - 9705469
SB  - IM
MH  - Humans
MH  - *Laryngoplasty
MH  - Prostheses and Implants
MH  - Vocal Cord Paralysis/*surgery
OTO - NOTNLM
OT  - maximum phonation time
OT  - medialization thyreoplasty
OT  - recurrent laryngeal nerve
OT  - subglottic pressure
OT  - vocal fold
EDAT- 2017/05/23 06:00
MHDA- 2017/07/08 06:00
CRDT- 2017/05/23 06:00
AID - PML250-173 [pii]
PST - ppublish
SO  - Pol Merkur Lekarski. 2017 Apr 21;42(250):173-177.