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Long-term voice outcomes of medialization thyroplasty with adjustable implant for unilateral vocal fold paralysis

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

Abstract

Objectives

Medialization thyroplasty (MT) using various implants has been employed as a corrective procedure for unilateral vocal fold paralysis (UVFP). A newly developed APrevent® vocal implant system (VOIS) offers an innovative solution with a finely adjustable design. This study aimed to investigate the long-term functional voice outcomes and benefits of postoperative adjustments in patients receiving MT using the VOIS-implant.

Methods

This is a prospective case series study at single tertiary medical center. Fourteen adult patients diagnosed with UVFP received MT with the VOIS implant and were followed up for more than 1 year. Implant adjustment procedure by injecting 0.9% physiological saline solution was performed both during and after the surgery to optimize glottal closure and voice quality. Objective voice outcomes and acoustic parameters were assessed preoperatively and postoperatively at various timepoints.

Results

Thirteen patients (93%) received intraoperative balloon adjustment, ranging from 0.05to 0.12 ml. Four patients underwent adjustments postoperatively and exhibited a positive trend towards immediately improving acoustic voice quality. Our long-term results demonstrated a notable improvement after the surgery in voice quality, with significant decreases in VHI-30 and improvements in perceptual parameters of GRBAS scale, acoustic measures such as jitter and signal-to-noise ratio (p < 0.001) and cepstral peak prominence smoothed in sustained vowel and short sentences. The voice outcomes remained stable more than 1 year follow-up.

Conclusions

Overall, MT with VOIS implantation provides a favorable long-term outcomes and stability in voice quality for patients with UVFP and also an effective tool for postoperative adjustment without major revision surgeries.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author.

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Funding

This work was supported by the National Science and Technology Council (Taiwan) under Grant No. MOST 111-2314-B-715-012-.

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Taipei City, 10449, Taiwan

    Po-Kai Huang, Yi-Hsuan Yu, Guan-Min Ho & Li-Chun Hsieh

  2. Department of Otolaryngology-Head and Neck Surgery, Communication Enhancement Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Chin-Kuo Chen

  3. School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Chin-Kuo Chen

  4. Department of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei, Taiwan

    Yi-Hsuan Yu & Li-Chun Hsieh

  5. Yomin ENT and Pediatric Clinic, Taipei, Taiwan

    Guan-Min Ho

  6. APrevent® Medical, Taipei, Taiwan

    Guan-Min Ho

  7. Department of Medicine, Mackay Medical College, New Taipei, Taiwan

    Li-Chun Hsieh

Authors
  1. Po-Kai Huang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by P-KH, Y-HY and L-CH. The first draft of the manuscript was written by P-KH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Guan-Min Ho or Li-Chun Hsieh.

Ethics declarations

Conflict of interest

Author Guan-Min Ho declares to be the inventor of the VOIS-Implant and standardized VOIS-Implantation procedure. Other authors declare that they have no conflict of interest. The authors have no other funding financial relationships, or conflicts of interest to disclose.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the institutional review board in Mackay Memorial Hospital (IRB no: 21MMHIS164e).

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Written informed consent was obtained from the patient for their anonymized information to be published in this article.

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Cite this article

Huang, PK., Chen, CK., Yu, YH. et al. Long-term voice outcomes of medialization thyroplasty with adjustable implant for unilateral vocal fold paralysis. Eur Arch Otorhinolaryngol 281, 1371–1378 (2024). https://doi.org/10.1007/s00405-023-08367-1

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  • DOI: https://doi.org/10.1007/s00405-023-08367-1

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