Skip to main content
SpringerLink
Log in

Voice quality improvement after management of unilateral vocal cord paralysis with different techniques

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology and Head & Neck Aims and scope Submit manuscript

Abstract

The aim of this study was to objectively evaluate the voices of patients suffering from unilateral vocal cord paralysis, before and after endoscopic augmentation and thyroplasty. In the past, we used injectable Teflon to treat this condition; later techniques included collagen injection and Isshiki thyroplasty. In the last 7 years, preferred treatment methods have included Bioplastique injection and lipoaugmentation of the vocal cords as well as medialization thyroplasty using a titanium implant according to Friedrich. Pre- and postoperative data was evaluated and compared to 25 patients. Appropriate glottic closure of the vocal cords was achieved in every case, in most cases after the first intervention. We used voice range profile measurements to evaluate the results. An objective evaluation was performed using the Friedrich dysphonia index. Significant improvements were found: the dysphonia index decreased in every case, from an average of 2.47, preoperatively, to an average of 1.18 postoperatively. In agreement with earlier studies, voice pitch range was the only parameter that not significantly improved. There was no statistical difference between the lipoaugmentation and thyroplasty according to Friedrich. We concluded that both endoscopic methods and thyroplasty can be used to achieve an optimal result. Cases must be evaluated individually so that the best technique, or combination of methods can be determined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Arnold GE (1955) Vocal rehabilitation of paralytic dysphonia: I. Cartilage injection into a paralysed vocal cord. Arch Otolaryngol 62:1

    CAS  Google Scholar 

  2. Arnold GE (1962) Vocal rehabilitation of paralytic dysphonia. IX. Technique of intracordal injection. Arch Otolaryngol 76:358–368

    Google Scholar 

  3. Brandenburg JH Danna Koschkee MA (1996) Lipoinjection laryngoplasty. Abstract of The second international symposium on laryngeal and tracheal reconstruction May 22–26, 1996, Monte-Carlo

  4. Brünings W (1911) Über eine neue Behandlungsmethode der Rekurrenslähmung. 18. Verhandl. Ver. Deutsch. Laryng., pp 93 (525), 151 (583)

  5. Cummings CW, Purcell LL, Flint PW (1993) Hydroxylapatite laryngeal implants for medialization. Preliminary report. Ann Otol Rhinol Laryngol 102:843–851

    PubMed  CAS  Google Scholar 

  6. Desrosiers M, Ahmarani C, Bettez M (1993) Precise vocal cord medialization using an adjustable laryngeal implant: a preliminary study. Otolaryngol Head Neck Surg 109:1014–1019

    PubMed  CAS  Google Scholar 

  7. Ford CN, Martin DW, Warner TF (1984) Injectable collagen in laryngeal rehabilitation. Laryngoscope 94:513–518

    Article  PubMed  CAS  Google Scholar 

  8. Friedrich G (1996) Qualitätssicherung in der Phoniatrie. Vorschlag zur Standardisierung der Klinischen Stimmprüfung HNO 44:401–416

  9. Friedrich G (1998) Externe Stimmlippenmedialisation: Funktionelle Ergebnisse. Laryngorhinootologie 77:18–26

    PubMed  CAS  Google Scholar 

  10. Friedrich G (1999) Titanium vocal fold medializing implant: introducing a novel implant system for external vocal fold medialization. Ann Otol Rhinol Laryngol 108:79–86

    PubMed  CAS  Google Scholar 

  11. Goff WF (1960) Laryngeal adductor paralysis treated by vocal cord injection of bone paste: a preliminary investigation. Trans Pac Coast Otoophtalmol Soc 41:77–88

    CAS  Google Scholar 

  12. Höfler H, Duman M (1993) Stimmlippenunterfütterung mit Bioplastique: erste Ergebnisse. Zentralbl. HNO 577–577

  13. Isshiki N, Morita H, Okamura H, Hiramoto M (1974) Thyroplasty as a new Phonosurgical technique. Acta Otolaryngol 78:451–457

    PubMed  CAS  Google Scholar 

  14. Isshiki N, Okamura H, Ishikawa T (1975) Thyroplasty type I (lateral compression) for dysphonia due to vocal cord paralysis or atrophy. Acta Otolaryngol (Stockh) 80:465–473

    CAS  Google Scholar 

  15. Kleinsasser O, Schroeder HG, Glanz H (1982) Medianverlagerung gelähmter Stimmlippen mittels Knorpelspanimplantation und Türflügelthyreoplastic. HNO 30:275–279

    PubMed  CAS  Google Scholar 

  16. Kresa Z, Rems J, Wichterle O (1973) Hydron gel implants in vocal cords. Acta Otolaryngol (Stockh) 76:360

    Article  CAS  Google Scholar 

  17. Lichtenberger G (2000) Diagnostik und Therapie ein- und beidseitiger Rekurrensparesen. Laryngo Rhino Otol 79:682–683

    Article  CAS  Google Scholar 

  18. Mahieu HF, Schutte HK (1989) New surgical techniques for voice improvement. Arch Otorhinolaryngol 246:397–402

    Article  PubMed  CAS  Google Scholar 

  19. McCulloch TM, Hoffman HT (1998) Medialization laryngoplasty with expanded polytetrafluoroethylene. Surgical technique and preliminary results. Ann Otol Rhinol Laryngol 107:427–432

    PubMed  CAS  Google Scholar 

  20. Montgomery MM, Blaugrund SM, Varvares MA (1993) Thyroplasty: a new approach. Ann Otol Rhinol Laryngol 102:571–579

    PubMed  CAS  Google Scholar 

  21. Montgomery MM, Montgomery SK (1997) Montgomery thyroplasty implant system. Ann Otol Rhinol Laryngol Suppl 170:1–16

    PubMed  CAS  Google Scholar 

  22. Payr E (1915) Plastik am Schildknorpel zur Behebung der Folgen einseitiger Stimmbandlähmung. Dtsch Med Wochenschr 43:1265–1270

    Google Scholar 

  23. Remacle MJM, Marbaix E, Bertrand BMG (1986) The value of injectable collagen in vocal and glottic rehabilitation. Arch Otorhinolaryngol 243:233–237

    Article  PubMed  CAS  Google Scholar 

  24. Rubin HJ (1965) Intracordal injection of silicone in selected dysphonias. Arch Otol 81:604

    CAS  Google Scholar 

  25. Schramm Jr VL, May M, Lavorato AS (1978) Gelfoam paste injection for vocal cord paralysis: temporary rehabilitation of glottic incompetence. Laryngoscope 88:1268–1273

    PubMed  CAS  Google Scholar 

  26. Sittel C, Thumfart WF, Pototschnig C, Wittekindt C, Eckel HE (2000) Textured polymethylsiloxane elastomers in the human larynx: safety and efficiency of use. J Biomed Mater Res 53:646–650

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of ORL and Head and Neck Surgery, Szent Rókus Hospital and Institutions, Gyulai Pál u.2, 1085, Budapest, Hungary

    A. Bihari, A. Reményi & G. Lichtenberger

  2. Department of Otorhinolaryngology, National Medical Center, Szabolcs u.35, 1135, Budapest, Hungary

    K. Mészáros

Authors
  1. A. Bihari
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. Mészáros
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Reményi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Lichtenberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Bihari.

Additional information

Presented at the 5th ELS Congress in Lisbon on 10-13 July 2004

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bihari, A., Mészáros, K., Reményi, A. et al. Voice quality improvement after management of unilateral vocal cord paralysis with different techniques. Eur Arch Otorhinolaryngol 263, 1115–1120 (2006). https://doi.org/10.1007/s00405-006-0116-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-006-0116-9

Keywords

Search

Navigation