Laryngeal aerodynamics after vocal fold augmentation with autologous fat vs thyroplasty in the same patient.
OBJECTIVE
To analyze laryngeal aerodynamics in the same patient in 4 different circumstances: before the onset of unilateral vocal fold paralysis (UVFP), after the onset of UVFP, and after 2 types of surgical vocal fold medialization techniques to compare the results of surgery with the measurements made in that same patient when his larynx was healthy (before paralysis).


METHODS
Prospective self-paired study of 1 male patient. Measurements were taken before iatrogenic UVFP (of the patient's healthy larynx), 1 week after the onset of iatrogenic UVFP (thoracic surgery), 3 days after vocal fold medialization with autologous fat, and 2 months after polytetrafluoroethylene thyroplasty.


METHODS
University hospital.


METHODS
Phonatory airflow and intraoral pressure.


RESULTS
Airflow and intraoral pressure increased after the onset of UVFP. Airflow decreased to preparalytic values after both types of vocal fold medialization. Intraoral pressure decreased after fat injection but increased after thyroplasty, despite the favorable effects of this treatment on laryngeal resistance and vocal efficiency compared with preparalytic values.


CONCLUSIONS
Our study demonstrates the variability of intraoral pressure as an indirect measure of subglottal pressure after vocal fold medialization in UVFP, due to as yet unknown factors. Phonatory airflow, laryngeal resistance, and vocal efficiency seem to be more reliable indicators of aerodynamic results after vocal fold medialization.
Hartl
Dana M
DM
Voice, Biomaterials, and Head and Neck Oncology Research Laboratory, European Hospital Georges Pompidou, Paris, France. hartl@igr.fr
Hans
Stéphane
S
Vaissière
Jacqueline
J
Brasnu
Daniel F
DF
D000273:Adipose Tissue; D000368:Aged; D001984:Bronchial Neoplasms / Q000503:physiopathology / Q000601:surgery; D005336:Fiber Optic Technology; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology*; D008175:Lung Neoplasms / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011013:Pneumonectomy; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D014826:Vocal Cord Paralysis / Q000503:physiopathology* / Q000601:surgery*; D014833:Voice Quality
D011138:Polytetrafluoroethylene