title: Long-term voice outcomes after thyroplasty for unilateral vocal fold paralysis.
abstract: OBJECTIVE
  To investigate the long-term clinical efficacy and stability of thyroplasty type I for unilateral vocal cord palsy, and to identify the appropriate timing of posttreatment evaluations for determination of long-term voice outcome. Study
  
  
  METHODS
  Single-institution retrospective study.
  
  
  METHODS
  Academic tertiary referral centers in Korea.
  
  
  METHODS
  Forty patients with unilateral vocal cord palsy who underwent thyroplasty from January 1, 1996, through December 31, 2006, and were followed up for at least 5 years after the surgical procedure.
  
  
  METHODS
  Thyroplasty type I under local anesthesia.
  
  
  METHODS
  Acoustic and aerodynamic analyses of voice were performed on the day before the operation and at preset intervals afterward. Two blinded speech-language pathologists performed the perceptual evaluation.
  
  
  RESULTS
  The GRBAS scale (grade of hoarseness, roughness, breathiness, asthenia, and strain) values showed significant improvement at 6 months after the operation (P < .05); these improvements continued up to 1 year and were maintained 5 years after the operation. Acoustic measurements of shimmer and jitter began to show significant improvement at 6 months after the operation, and fundamental frequency and noise harmonic ratios evidenced significant improvement at 1 year (P < .05); these improvements were maintained, to a significant extent, at 5 years after the operation. Aerodynamically, the maximum phonation time, glottal flow rate, and peak subglottic pressure improved significantly from before the operation to 6 months and 1 year after the operation, attaining near-normal values at 1 year afterward (P < . 05)
  
  
  CONCLUSIONS
  Thyroplasty type I may provide evidence that voice outcome progressively evolves during the first years after the surgical procedure, and that subsequent vocal improvement presented long-lasting stabilization. To assess the long-term voice quality, it may be enough to perform the voice evaluation at 1 year after the procedure.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: In Sun
authors.initials: IS
authors.lastname: Ryu
authors.forename: Soon Yuhl
authors.initials: SY
authors.lastname: Nam
authors.forename: Myung Woul
authors.initials: MW
authors.lastname: Han
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Jong-Lyel
authors.initials: JL
authors.lastname: Roh
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000772:Anesthesia, Local; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D013061:Speech Acoustics; D018709:Statistics, Nonparametric; D013957:Thyroid Cartilage / Q000601:surgery*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014833:Voice Quality