Zimmermann Terence M, Orbelo Diana M, Pittelko Rebecca L, Youssef Stephanie J, Lohse Christine M, Ekbom Dale C
Department of Otorhinolaryngology, Rochester, Minnesota, U.S.A.
Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A.
Laryngoscope. 2019 Aug;129(8):1876-1881. doi: 10.1002/lary.27684. Epub 2018 Dec 24.
Voice outcomes following medialization laryngoplasty (ML) for unilateral vocal fold paralysis (UVFP) were compared to those who underwent ML plus arytenoid adduction (AA) (ML+AA).
Single institution retrospective review of patients with UVFP undergoing ML and ML+AA (2009-2017). Demographic information and history of laryngeal procedures were collected. Preoperative and postoperative Voice Handicap Index-10 (VHI-10) and Consensus Perceptual Auditory Evaluation of Voice (CAPE-V) were assessed.
Of 236 patients, 119 met study criteria. Of those, 70 (59%) underwent ML and 49 (41%) underwent ML+AA. Significant differences between groups at baseline were found for age at time of thyroplasty (P = 0.046), VHI-10 scores (P < 0.001), and CAPE-V scores (P = 0.007). Baseline VHI-10 scores for ML+AA (28 ± 7) were greater than those for ML alone (24 ± 7). At 12 months, overall VHI-10 scores improved compared to baseline for both groups (ML+AA = 9 ± 7, ML = 16 ± 9); however, there was greater improvement for the ML+AA group compared to ML group (P = 0.001). CAPE-V scores at 3 or 12 months improved, but differences between the groups were not statistically significant once controlled for covariates.
Based on current findings, patients who undergo ML+AA likely have greater voice handicap at baseline compared to those undergoing ML alone. Patients selected for ML+AA improve as much or more than those who underwent ML alone. This highlights the importance of appropriate selection of candidates for AA.
4 Laryngoscope, 129:1876-1881, 2019.
比较单侧声带麻痹（UVFP）患者接受喉内移术（ML）与接受喉内移术联合杓状软骨内收术（AA）（ML+AA）后的嗓音结果。
对一家机构2009年至2017年间接受ML和ML+AA治疗的UVFP患者进行单机构回顾性研究。收集人口统计学信息和喉部手术史。评估术前和术后的嗓音障碍指数-10（VHI-10）和嗓音的共识听觉感知评估（CAPE-V）。
236例患者中，119例符合研究标准。其中，70例（59%）接受了ML，49例（41%）接受了ML+AA。两组在基线时的差异在甲状成形术时的年龄（P = 0.046）、VHI-10评分（P < 0.001）和CAPE-V评分（P = 0.007）方面有显著差异。ML+AA组的基线VHI-10评分（28±7）高于单纯ML组（24±7）。在12个月时，两组的总体VHI-10评分均较基线有所改善（ML+AA = 9±7，ML = 16±9）；然而，ML+AA组的改善程度高于ML组（P = 0.001）。3个月或12个月时的CAPE-V评分有所改善，但在控制协变量后，两组之间的差异无统计学意义。
根据目前的研究结果，与单纯接受ML的患者相比，接受ML+AA治疗的患者在基线时可能有更大的嗓音障碍。选择接受ML+AA治疗的患者与接受单纯ML治疗的患者改善程度相同或更大。这突出了适当选择AA候选人的重要性。
4《喉镜》，129:1876 - 1881，2019年。
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