title: Novel approach of medialization thyroplasty with arytenoid adduction performed under general anesthesia with a laryngeal mask.
abstract: OBJECTIVE
  To objectively assess the voice outcomes of patients with unilateral vocal fold paralysis treated with medialization thyroplasty and arytenoid adduction suture.
  
  
  METHODS
  Case series of patients who underwent medialization thyroplasty and arytenoid adduction suture. Preoperative and postoperative voice testing was performed and the data were compared by statistical analysis.
  
  
  METHODS
  Tertiary referral teaching hospital in Sydney, Australia.
  
  
  METHODS
  All patients had a unilateral vocal fold paralysis, with a large posterior glottic gap and vocal symptoms affecting their quality of life.
  
  
  METHODS
  Thirteen patients with a diagnosis of a unilateral vocal fold paralysis with a large posterior glottic gap, vocal symptoms, and total denervation of the vocal fold underwent medialization thyroplasty and arytenoid adduction suture. The surgery was performed in a novel method under a general anesthetic using a laryngeal mask and with direct intraoperative endoscopic feedback. Preoperative and postoperative measures of voice performance were compared, including acoustic analysis (fundamental frequency, speech intensity against quiet and loud background noise, speech rate) and aerodynamic assessment (airflow, maximum phonation time).
  
  
  RESULTS
  Medialization thyroplasty with arytenoid adduction suture significantly improved aerodynamic assessment and phonation duration for both male and female subjects overall. There were 2 of 13 treatment failures. Median follow-up time was 6 months.
  
  
  CONCLUSIONS
  Preliminary results indicate that in selected patients with vocal fold paralysis, medialization thyroplasty with arytenoid adduction suture leads to significant improvements in objective voice measures. Longer follow-up data are required to further quantify the voice outcomes after this procedure.
authors.affiliation: Department of Otolaryngology, Mona Vale Hospital, NSW Australia.
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Stow
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Lee
authors.forename: Ian E
authors.initials: IE
authors.lastname: Cole
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001193:Arytenoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D017214:Laryngeal Masks; D058753:Laryngoplasty; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013537:Sutures; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality