title: Cricothyroid approximation for voice and swallowing rehabilitation of high vagal paralysis secondary to skull base neoplasms.
abstract: This study documents the speech and swallowing outcomes of isolated ipsilateral cricothyroid approximation (aka tensioning thyroplasty; Type IV thyroplasty) for the treatment of high vagal paralysis (combined superior laryngeal nerve and recurrent laryngeal nerve paralysis). This is a pilot study of five cases with high vagal paralysis consequent to skull base neoplasms. Unilateral cricothyroid tensioning sutures were used. In all cases, vocal fold tensioning and vertical realignment of lax vocal folds were achieved. A partial, but acceptable medialization of vocal cord position was achieved. In all cases, aspiration was minimized and normal swallow function was restored by 6 weeks. The voice outcome was excellent in four cases and acceptable in one. Cricothyroid approximation restores vocal fold tension; in addition, it restores vertical vocal fold position and partially restores horizontal vocal fold position. Good voice and swallowing outcomes have been achieved. The procedure is quick, safe, and convenient when combined with a skull-base excision procedure. Further evaluation is merited.
authors: Department of Otolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors: Alok
authors: A
authors: Thakar
authors: Kapil
authors: K
authors: Sikka
authors: Rohit
authors: R
authors: Verma
authors: C
authors: C
authors: Preetam
mesh_terms: D000328:Adult; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007821:Laryngeal Muscles / Q000294:innervation / Q000601:surgery*; D058753:Laryngoplasty / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010865:Pilot Projects; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000150:complications* / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014630:Vagus Nerve / Q000503:physiopathology; D020421:Vagus Nerve Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D014833:Voice Quality