title: Voice outcomes following the gray minithyrotomy.
abstract: OBJECTIVE
  Most practitioners have limited treatment options for vocal fold scar and sulcus vocalis. The Gray minithyrotomy (GMT) is a surgical procedure for the treatment of these conditions, although limited objective data exist regarding voice outcomes. This study compares the quantified subjective and visual perceptual outcomes following GMT for the treatment of vocal fold scar and sulcus vocalis.
  
  
  METHODS
  We performed a retrospective review of patients who underwent GMT in a single institution. Patient-reported satisfaction, Voice Handicap Index-10 scores, results of video perceptual analysis, and complications were recorded.
  
  
  RESULTS
  Sixteen patients underwent GMT for phonotraumatic or postoperative scar (11), radiation-induced scar (3), or sulcus vocalis (2). Seven underwent bilateral operations. Follow-up data were available for 12 patients. Eight patients had 2 or more failed surgical interventions before GMT. Seven of the 13 procedures resulted in a self-reported improvement. Although the mean preoperative Voice Handicap Index-10 score (30.6) across all patients did not decrease after the operation, 6 of the 13 GMT procedures resulted in improvement (mean decrease, 7.5). Complications, encountered in 5 patients, included ecchymosis, neck abscess, tongue numbness, wound dehiscence, and aspiration pneumonia.
  
  
  CONCLUSIONS
  The GMT is a viable treatment for severe vocal fold scar and sulcus vocalis. Our results show improvement in half of a cohort that was marked by previous failures at improving voice. These results point to the recalcitrant nature of voice difficulties in treating vocal fold scar and sulcus, and may properly guide clinicians and patients in their expectations following this infrequently used technique.
authors: Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15219, USA.
authors: Pavan S
authors: PS
authors: Mallur
authors: Jacqueline
authors: J
authors: Gartner-Schmidt
authors: Clark A
authors: CA
authors: Rosen
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000328:Adult; D000368:Aged; D002921:Cicatrix / Q000473:pathology / Q000601:surgery; D055154:Dysphonia / Q000209:etiology / Q000601:surgery*; D005205:Fascia / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D013957:Thyroid Cartilage / Q000601:surgery; D014827:Vocal Cords / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D014833:Voice Quality