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Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea

  • Laryngology
  • Published:
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Abstract

In unilateral vocal cord paralysis (UVCP), hoarseness is usually the leading symptom; however, the diminished airway might lead to breathing problems as well, especially with exertion. The application of the classic resection glottis enlarging or medialization procedures might shift the breathing and/or the voice to a worse condition. The non-destructive endoscopic arytenoid abduction lateropexy (EAAL) might be a solution for this problem. The aim of our study was to analyze the phonatory and respiratory outcomes of this treatment concept. The first year phoniatric [Jitter, Shimmer, harmonics-to-noise ratio (HNR), maximum phonation time (MPT), fundamental frequency (F 0), Voice Handicap Index (VHI), Dysphonia Severity Index (DSI), Global-Roughness-Breathiness scale (GRB)], peak inspiratory flow (PIF), and quality of life (QoL) were evaluated in ten UVCP patients treated by EAAL for dyspnea generally presented on exertion. PIF, Jitter, QoL, GRB, and VHI significantly improved. DSI, HNR, and MPT got non-significantly better. F 0 slightly increased in all patients, a mild deterioration of shimmer was observed. These results prove that improving respiratory function is not necessarily associated with a deterioration in voice quality. The EAAL provides a significant improvement in breathing and the vibratory parameters of the postoperative, more tensed and straightened vocal cords proved to be more advantageous than the original (para) median ‘loose’ position. The over-adduction of the contralateral side more or less compensates for the disadvantageous, more lateral position of the operated side. EAAL might be an alternative treatment for unilateral vocal cord paralysis associated with breathing problems.

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Acknowledgements

The authors wish to thank Dr. Kathleen I. Castellanos for reviewing the manuscript. Her assistance is greatly appreciated.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, University of Szeged, Tisza Lajos krt. 111, Szeged, 6725, Hungary

    Vera Matievics, Adam Bach, Balazs Sztano, Zsofia Bere, Zoltan Tobias & Laszló Rovo

  2. Department of Otolaryngology, Voice and Aerodigestive Center, University of Alabama at Birmingham, Birmingham, USA

    Paul F. Castellanos

  3. Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany

    Andreas H. Mueller

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  1. Vera Matievics
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  2. Adam Bach
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  5. Zoltan Tobias
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  6. Paul F. Castellanos
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  7. Andreas H. Mueller
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  8. Laszló Rovo
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Correspondence to Adam Bach.

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Funding

The authors declare that no funding has been received for the conduct of this study or preparation of this manuscript.

Conflict of interest

Vera Matievics declares that she has no conflict of interest. Adam Bach declares that he has no conflict of interest. Balazs Sztano declares that he has no conflict of interest. Zsofia Bere declares that she has no conflict of interest. Zoltan Tobias declares that he has no conflict of interest. Paul F. Castellanos declares that he has no conflict of interest. Andreas H. Mueller declares that he has no conflict of interest. Laszlo Rovo declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Vera Matievics and Adam Bach are first authors.

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Matievics, V., Bach, A., Sztano, B. et al. Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea. Eur Arch Otorhinolaryngol 274, 3703–3710 (2017). https://doi.org/10.1007/s00405-017-4696-3

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  • DOI: https://doi.org/10.1007/s00405-017-4696-3

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