Department of Otolaryngology, Tohoku Rosai Hospital, 4-3-21 Dainohara, Aoba-ku, Sendai, Miyagi, 981-8563, Japan.
Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
Eur Arch Otorhinolaryngol. 2023 Nov;280(11):5011-5017. doi: 10.1007/s00405-023-08165-9. Epub 2023 Aug 16.
Laryngeal framework surgery, including medialization laryngoplasty and arytenoid adduction (AA), is expected to have a lasting or permanent effect in patients with unilateral vocal fold paralysis (UVFP); however, there are few reports about the long-term outcomes of AA. This study aimed to evaluate the long-term postoperative effects of AA surgery and examine its stability and reliability.
This study collected the voice handicap index (VHI) questionnaire from patients with UVFP who underwent AA more than 2 years previously. The VHI values preoperatively and 3 months postoperatively (early postoperative evaluation) were retrospectively calculated, and VHI values more than 2 years after surgery (late postoperative evaluation) were collected by mailing a sheet to the patients and asking to fill and return it. Possible influenced subscales such as age, sex, causes of UVFP, affected side, and surgeons were also analyzed.
A total of 77 patients with UVFP who underwent AA had significantly lower early and late postoperative evaluations than preoperative evaluations. In 38 patients with no missing values, there were no significant differences between early and late postoperative evaluations, measured at a median of approximately 5 years. There were also no significant differences between early and late postoperative evaluations in any of the subscale groups.
Patients with UVFP who underwent AA surgery achieved stable voice improvement in the long term after surgery.
喉框架手术，包括声带内移术和杓状软骨内收术（AA），预计对单侧声带麻痹（UVFP）患者具有持久或永久的效果；然而，关于 AA 的长期结果的报道很少。本研究旨在评估 AA 手术的长期术后效果，并检验其稳定性和可靠性。
本研究收集了 2 年以上接受 AA 手术的单侧声带麻痹患者的嗓音障碍指数（VHI）问卷。回顾性计算术前和术后 3 个月（早期术后评估）的 VHI 值，并通过邮寄问卷给患者，要求填写并寄回，收集术后 2 年以上（晚期术后评估）的 VHI 值。还分析了可能受影响的亚量表，如年龄、性别、UVFP 病因、受累侧和术者。
77 例接受 AA 的单侧声带麻痹患者的早期和晚期术后评估明显低于术前评估。在 38 例无缺失值的患者中，术后约 5 年的中期测量结果显示，早期和晚期术后评估无显著差异。在任何亚量表组中，早期和晚期术后评估也没有显著差异。
接受 AA 手术的单侧声带麻痹患者在手术后长期获得稳定的嗓音改善。
