title: [Sternum-hyoid muscle transposition and arytenoid adduction for unilateral vocal cord paralysis].
abstract: OBJECTIVE
  To explore the therapeutic effect of sternum-hyoid muscle transposition and arytenoid adduction for unilateral vocal cord paralysis (UVCP).
  
  
  METHODS
  Included in this study were 19 patients with UVCP lasted for 12 months to 15 years. The surgical technique was as follows. The thyroid cartilage was engaged with a skin hook and gently rotated anteriorly. The lateral-inferior corner of the thyroid cartilage was exposed and the muscular process of the arytenoid was identified. Then, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. The lamina was retracted laterally, and a 3-0 prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid muscle. A bipedicled strap muscle flap was then transposed into the space between the lamina and the inner perichondrium. Pre- and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, harmonic ratio and maximal phonation time, as well as assessments of voice quality.
  
  
  RESULTS
  Vocal improvement was obtained in 100% (19 of 19) of patients. Immediately after the operation, the ingression could be observed in vocal cord membrane and vocal process, vocal cord volume was amplified. There was a significant difference (P < 0.05) in all parameters (fundamental frequency, jitter, shimmer, harmonic ratio and maximal phonation time) between pre- and postoperative voice evaluations measured mean. There was no significant difference (P > 0.05) in voice evaluations measured mean between 2 months and 12 months after operation in all patients. No major complications were noted in any patient.
  
  
  CONCLUSIONS
  Sternum-hyoid muscle transposition and arytenoid adduction for unilateral vocal cord paralysis is simple and convenient, no immune rejection, and the long-term result is stable.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
authors.forename: Shi-cai
authors.initials: SC
authors.lastname: Chen
authors.forename: Dong-hui
authors.initials: DH
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Jian-bin
authors.initials: JB
authors.lastname: Shi
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.forename: Hong-liang
authors.initials: HL
authors.lastname: Zheng
mesh_terms: D000328:Adult; D001193:Arytenoid Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000637:transplantation; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality