title: Arytenoid rotation and nerve-muscle pedicle transfer in paralytic dysphonia.
abstract: OBJECTIVE
  Our objective was to evaluate the efficacy of modified nerve-muscle pedicle (NMP) flap transfer combined with arytenoid adduction (AA) (AA + modified NMP) for treatment of unilateral vocal fold paralysis. The patterns of voice outcome assessed using phonatory function tests and auditory perceptual judgments were followed-up for 2 years.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Thirteen subjects among those presented with paralytic dysphonia between March 2002 and December 2008 were treated with AA + modified NMP. The voice outcomes (six objective and two subjective voice parameters) were evaluated preoperatively and in four different time points postoperatively over 2-years duration.
  
  
  RESULTS
  All voice parameters showed initial postoperative improvement. Moreover, five parameters showed significant continuous improvement over the 2-year follow-up (maximum phonation time, pitch range, shimmer, and grade overall and breathiness of the grade-roughness-breathiness-asthenia-strain scale (GRBAS), whereas two parameters revealed continuous improvement over the first 12 to 14 months after surgery (mean flow rate and harmonics-to-noise ratio).
  
  
  CONCLUSIONS
  AA + modified NMP improves both short- and long-term voice outcomes in unilateral vocal fold paralysis patients. Therefore, AA + modified NMP is an effective surgical combination for the treatment of severe paralytic dysphonia.
authors.affiliation: Unit of Phoniatrics-Department of Otolaryngology, Faculty of Medicine, Sohag University, Sohag, Egypt.
authors.forename: Megahed M
authors.initials: MM
authors.lastname: Hassan
authors.forename: Eiji
authors.initials: E
authors.lastname: Yumoto
authors.forename: M Ali
authors.initials: MA
authors.lastname: Baraka
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Sanuki
authors.forename: Narihiro
authors.initials: N
authors.lastname: Kodama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001193:Arytenoid Cartilage; D055154:Dysphonia / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013524:Surgical Flaps; D014826:Vocal Cord Paralysis / Q000150:complications* / Q000601:surgery*