Type I gore-tex laryngoplasty for glottic incompetence in mobile vocal folds.
OBJECTIVE
To determine the effectiveness of gore-tex medialization thyroplasty for the management of glottic incompetence (GI) in patients with mobile vocal folds.


METHODS
Twenty patients with glottic incompetence (GI) and mobile vocal folds were retrospectively analyzed after gore-tex medialization laryngoplasty. Pre- and postoperative outcome measures including grade, roughness, breathiness, asthenia, strain of the voice (GRBAS), glottal function index (GFI), and voice-related quality of life (VRQOL) were compared to detect surgical effectiveness. Two anesthetic subgroups were identified and compared: general anesthesia, via laryngeal mask airway (LMA) anesthetic, and local anesthesia.


RESULTS
Statistically significant differences were identified between pre- and postoperative VRQOL (P<0.0001), GFI (P<0.01), and composite GRBAS (P<0.0001) after a mean follow-up time of 7.8 months. Both the LMA and the local anesthetic subgroups demonstrated similar significance across these measures. GFI and VRQOL scores demonstrate a moderate correlation (ρ=0.71). Perceptual voice quality (GRBAS) correlates slightly better with VRQOL scores (ρ=-0.6; P<0.01) than qualitative measures of glottal function (GFI) (ρ=0.43).


CONCLUSIONS
Gore-tex thyroplasty provides reliable medium-term improvement in both perceptual and subjective voice parameters in the setting of GI with mobile vocal folds.
UNC Voice Center, University of North Carolina Department of Otolaryngology-Head and Neck Surgery, Chapel Hill, North Carolina, USA. rbuckmir@unch.unc.edu
Robert A
RA
Buckmire
Paul C
PC
Bryson
Mihir R
MR
Patel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000295:instrumentation; D000772:Anesthesia, Local; D001696:Biomechanical Phenomena; D055154:Dysphonia / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D017214:Laryngeal Masks; D058753:Laryngoplasty / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010699:Phonation; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D013067:Speech Perception; D013068:Speech Production Measurement; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality; D055815:Young Adult
D011138:Polytetrafluoroethylene