title: Medialization of paralyzed vocal fold does not increase respiratory resistance measured by impulse oscillometry.
abstract: Injection laryngoplasty restores voice in subjects with unilateral vocal fold paralysis, but knowledge of its effects on airflow dynamics is limited. Impulse oscillometry (IOS) is a non-invasive technique to investigate airway resistance. It is easily performed during normal breathing. A prospective study was conducted in order to investigate the effects of autologous fascia injection on airflow dynamics. IOS, flow-volume spirometry, acoustic analysis of voice, voice handicap index (VHI) questionnaire and subjective dyspnoea score were recorded before and 5-11 months after the operation. There was no significant change in respiratory resistance (Rres) or other variables of IOS. FEV1/FVC decreased from 0.80 to 0.77 (P = 0.02), but other variables of spirometry did not change significantly. Acoustic properties of voice (noise-to-harmonics ratio, shimmer, jitter, maximal phonation time) and VHI improved significantly. No change in dyspnoea occurred. In conclusion, medializing of a paralysed vocal fold improves voice, but does not have a clinically significant adverse effect on breathing. Flow-volume spirometry is more sensitive than IOS to changes in airflow dynamics after medialization.
authors.affiliation: Department of Respiratory Medicine, Central Finland Health Care District, Kinkomaa Hospital, 40930, Kinkomaa, Finland. antti.saarinen@ksshp.fi
authors.forename: Antti
authors.initials: A
authors.lastname: Saarinen
authors.forename: Anssi R A
authors.initials: AR
authors.lastname: Sovijärvi
authors.forename: Lauri
authors.initials: L
authors.lastname: Karhumäki
authors.forename: Heikki
authors.initials: H
authors.lastname: Rihkanen
mesh_terms: D000403:Airway Resistance; D004185:Disability Evaluation; D004867:Equipment Design; D005205:Fascia / Q000166:cytology / Q000637:transplantation; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009991:Oscillometry / Q000295:instrumentation*; D012119:Respiration; D013061:Speech Acoustics; D013147:Spirometry; D011795:Surveys and Questionnaires; D014826:Vocal Cord Paralysis / Q000175:diagnosis*; D014833:Voice Quality