Voice Improvement after Medialization Thyroplasty in
Unilateral Vocal Fold Paralysis
Premyot Ngaotepprutaram MD 1 , Todsaporn Nakarat MD 2 ,
Kanjana Aumsompong MA (Communication Disorders) 1 , Netra Buakanok MA (Communication Disorders) 1 , Chanticha Chotigavanich MD 1 , Cheerasook Chongkolwatana MD 1
Affiliation :
1 Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Samitivej Srinakarin Hospital, Bangkok, Thailand
Objective : To evaluate both subjective and objective voice changes after medialization thyroplasty in patients with unilateral vocal
fold paralysis, and to assess the time to achieve maximum voice improvement after surgery.
Materials and Methods : Nineteen patients with unilateral vocal fold paralysis and undergoing medialization thyroplasty were
recruited from May 2006 to December 2008. Voice recordings were performed before surgery and at 2, 4 and 6 months after
surgery. Acoustic analysis (fundamental frequency, highest fundamental frequency, lower fundamental frequency, noise-to-harmonic
ratio, and percent of jitter and shimmer) was calculated using the Multidimensional Voice Program. Maximum phonation time,
perceptual evaluation, and a self-assessment visual analogue scale were also conducted. Data for the preoperative and three
postoperative periods were compared.
Results : Jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time showed significant improvements after medialization
thyroplasty, and maximum improvement was found at the second postoperative month, with no significant change among the three
postoperative periods. Subjective voice quality and loudness showed maximum improvement at the fourth and sixth months,
respectively. Patients’ self-assessment by visual analogue scale showed maximum improvement at the fourth postoperative, with
up to 80% of their normal voice.
Conclusion : All objective measurements revealed maximum voice improvement at the second month after medialization thyroplasty,
with marginal improvement thereafter. The subjective measurements demonstrated an improvement up to 80% of normal voice
after surgery.
Keywords : Medialization thyroplasty, Laryngoplasty, Vocal fold paralysis, Voice, Acoustic analysis, Aerodynamic analysis
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