title: Long-term voice handicap index after type II thyroplasty using titanium bridges for adductor spasmodic dysphonia.
abstract: OBJECTIVE
  To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis.
  
  
  METHODS
  Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with the VHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB).
  
  
  RESULTS
  The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery.
  
  
  CONCLUSIONS
  The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kumamoto University School of Medicine, Kumamoto, Japan. Electronic address: otostl0319@fc.kuh.kumamoto-u.ac.jp.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Sanuki
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kumamoto University School of Medicine, Kumamoto, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Yumoto
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kumamoto University School of Medicine, Kumamoto, Japan.
authors.forename: Narihiro
authors.initials: N
authors.lastname: Kodama
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kumamoto University School of Medicine, Kumamoto, Japan.
authors.forename: Ryosei
authors.initials: R
authors.lastname: Minoda
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Kumamoto University School of Medicine, Kumamoto, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kumai
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D055154:Dysphonia / Q000601:surgery*; D005260:Female; D006801:Humans; D058753:Laryngoplasty / Q000379:methods*; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome; D014833:Voice Quality; D055815:Young Adult
keywords: Acoustic analysis; Adductor spasmodic dysphonia; Type II thyroplasty; VHI-10