title: Evaluation of open approach and injection laryngoplasty in revision thyroplasty procedures.
abstract: BACKGROUND
  Vocal outcomes after medialization laryngoplasty are variable and may change over time. A revision procedure via open approach or an injection laryngoplasty may be necessary to improve vocal outcomes.
  
  
  METHODS
  A retrospective chart review was performed.
  
  
  RESULTS
  Twenty-nine subjects were identified and stratified into group 1A (n = 9) if the allograft was repositioned/replaced, group 1B (n = 4) if the allograft was removed, and group 2 (n = 16) if an injection laryngoplasty was performed. Statistically significant differences were found between all data prerevision to postrevision (P < or = 0.05) for group 1A and group 2 when multiple paired-sample t tests were calculated for patient-reported voice severity ratings and voice impact ratings as well as clinician-reported voice ratings of grade, roughness, and breathiness. Results of group 2 were often temporary, with 10 of 16 (62.5%) subjects receiving multiple injections.
  
  
  CONCLUSIONS
  Both open revision laryngoplasty and injection laryngoplasty are successful at providing improved vocal outcomes. Results are often temporary after injection laryngoplasty and often require multiple procedures.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Andrews
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Van Daele
authors.forename: Michael P
authors.initials: MP
authors.lastname: Karnell
authors.forename: Timothy M
authors.initials: TM
authors.lastname: McCulloch
authors.forename: Scott M
authors.initials: SM
authors.lastname: Graham
authors.forename: Henry T
authors.initials: HT
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000008:administration & dosage; D002648:Child; D017886:Durapatite / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D013957:Thyroid Cartilage / Q000601:surgery*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality
chemical_list: D001672:Biocompatible Materials; D017886:Durapatite