Long-term results of different treatment modalities for glottic insufficiency.
OBJECTIVE
The purpose of this study was to investigate the early and long-term functional results of thyroplasty type-I and injection laryngoplasty using fat or calcium hydroxylapatite.


METHODS
Thirty patients with glottic insufficiency were included and followed up between 1-7 years. Patients with glottic bowing or sulcus vocalis were selected for injection augmentation of the vocal folds, while those with unilateral vocal fold immobility underwent medialization thyroplasty. Perceptual and acoustic analysis of voice, and videolaryngostroboscopy were performed before and after surgery.


RESULTS
After the surgery, GRBAS scale of all patients demonstrated significant change in grade of severity, roughness, and breathiness. Acoustic analysis demonstrated significant change in Fo, jitter, shimmer, noise to harmonic ratio, and maximum phonation time (MPT) in thyroplasty group, while those demonstrated significant change in Fo (lowest) and jitter, and MPT in injection augmentation group.


CONCLUSIONS
Medialization thyroplasty is the gold standard for the management of glottic insufficiency, regardless of the severity of glottic gap. However, injection augmentation of the vocal folds may be considered as an alternative in the treatment of patients with small glottic gap. Further studies with larger groups and long follow-up periods are required to figure out the proper material for injection laryngoplasty.
Ankara University Faculty of Medicine, Otorhinolaryngology, Ankara, Turkey.
Gursel
G
Dursun
Serife
S
Boynukalin
Ozan Bagis
OB
Ozgursoy
Isil
I
Coruh
D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D000368:Aged; D001284:Atrophy; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014833:Voice Quality