title: Subtotal carbon dioxide laser arytenoidectomy for the treatment of bilateral vocal fold immobility: long-term results.
abstract: Sixty-nine patients underwent subtotal carbon dioxide laser arytenoidectomy for treatment of bilateral vocal fold immobility between 1985 and 2000. The population included 69 patients whose mean age was 56 years (SD, 16 years; range, 11 to 82 years). The mean follow-up was 50 months (SD, 44 months; range, 1 to 181 months). The overall postoperative peak expiratory/peak inspiratory flow ratio (normal value, 1) significantly improved (closer to 1; p = .0036). Voice analyses were also undertaken for 27 patients, almost exclusively after operation, given the context of initial emergency. The maximum phonation time averaged 6.57 seconds (median, 6 seconds). The phonation quotient remained high, with a mean of 503 (median, 440), and the mean conversational voice intensity remained around 59 dB. The median frequency analysis type was 3. The advantage of subtotal arytenoidectomy lies in the fact that it maintains a certain degree of rigidity along the posterior limit of the arytenoid frame, preventing inward collapse of the mucosa and thus lowering the risk of aspiration.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Louvain University Hospital, 5530 Yvoir, Belgium.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Plouin-Gaudon
authors.forename: Georges
authors.initials: G
authors.lastname: Lawson
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.forename: Marc
authors.initials: M
authors.lastname: Remacle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001193:Arytenoid Cartilage / Q000601:surgery*; D002245:Carbon Dioxide; D002648:Child; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000601:surgery*; D014833:Voice Quality
chemical_list: D002245:Carbon Dioxide