title: Short-term treatment results for unilateral vocal fold palsy induced by mediastinal lesions.
abstract: OBJECTIVE
  Vocal fold paralysis (VFP) is a frequent complication of surgery of mediastinal structures. This study evaluated the characteristics and short-term treatment outcomes of injection laryngoplasty for unilateral VFP (UVFP) induced by mediastinal lesions.
  
  
  METHODS
  The enrolled patients (n = 60) underwent injection laryngoplasty once because of UVFP and were divided into two groups according to cause (group A, thyroidectomy and group B, mediastinal surgery). Voice analysis was performed preoperatively and at 1 month postoperatively. The glottal gap; the Grade, Roughness, Breathiness, Asthenia, and Strain scale; acoustic analysis; and aerodynamic results were measured.
  
  
  RESULTS
  Group A and group B comprised eight and 52 patients, respectively. Group B patients were older than group A patients (P < 0.05). The injected volume in group B (0.91 ± 0.23 mL) was larger than that of group A (0.38 ± 0.17 mL; P = 0.022). Group B (13.35 ± 4.69 units) showed a larger glottal gap than group A (6.64 ± 4.05 units; P = 0.017), and the glottal gap decreased after the procedure. In both groups, most preoperative acoustic parameters except roughness improved after injection laryngoplasty. The preoperative maximum phonation time of group B (2.87 ± 1.11 seconds) was shorter than that of group A (7.04 ± 2.58 seconds), and it improved after injection. Mean airflow rate improved significantly after injection in both groups.
  
  
  CONCLUSIONS
  Mediastinal lesion-induced UVFP is associated with a larger glottal gap than that caused by an injury induced by thyroidectomy. Despite large glottal gap, injection laryngoplasty improves voice outcomes in such types of UVFP.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yoon Se
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yong-Hee
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Minsu
authors.initials: M
authors.lastname: Kwon
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.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Go-Eun
authors.initials: GE
authors.lastname: Jung
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seong-Tae
authors.initials: ST
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jong-Lyel
authors.initials: JL
authors.lastname: Roh
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: synam@amc.seoul.kr.
authors.forename: Soon-Yuhl
authors.initials: SY
authors.lastname: Nam
mesh_terms: D000162:Acoustics; D000328:Adult; D005260:Female; D006801:Humans; D007267:Injections; D058753:Laryngoplasty / Q000009:adverse effects / Q000379:methods; D008297:Male; D008482:Mediastinum / Q000601:surgery*; D008875:Middle Aged; D010699:Phonation; D020127:Recovery of Function; D061226:Recurrent Laryngeal Nerve Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D013965:Thyroidectomy / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality; D055815:Young Adult
keywords: Laryngoplasty; Vocal fold paralysis; Voice quality