title: Voice and respiratory outcomes after permanent transoral surgery of bilateral vocal fold paralysis.
abstract: OBJECTIVE
  Bilateral vocal fold paralysis (BVFP) is a rare but life-threatening condition mostly caused by iatrogenic damage to the peripheral recurrent laryngeal nerve. Endoscopic enlargement techniques have been the standard treatment for decades. However, prospective studies using internationally accepted phoniatric and respiratory evaluation guidelines are rare.
  
  
  METHODS
  Prospective observational multicenter study.
  
  
  METHODS
  Twelve clinical centers screened 61 patients, of whom 36 were eligible according to the study protocol. Subjects were assessed with specific phoniatric and respiratory tests preoperatively and at 1 and 6 months postoperatively.
  
  
  RESULTS
  Important respiratory parameters improved significantly 6 months postoperatively (peak expiratory and expiratory flow), confirming that a glottal enlargement effectively reduced the obstruction. Objective parameters dealing with voice quality worsened significantly (maximum phonation time, voice range profile, hoarseness), whereas subjective voice assessment (VHI-12) did not change significantly.
  
  
  CONCLUSIONS
  Endoscopic glottal enlargement is an effective method for relieving symptoms of dyspnea due to BVFP. Postoperatively, voice quality objectively worsened; however, this was not perceived by the patients themselves. Laryngostroboscopic findings did not correlate strongly with voice and respiratory outcomes.
  
  
  METHODS
  2b.
authors.affiliation: Department of Audiology and Phoniatrics, Charité-Medical University of Berlin, Berlin, Germany.
authors.forename: Tadeus
authors.initials: T
authors.lastname: Nawka
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Katharinenhospital Stuttgart, Stuttgart, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Sittel
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Arens
authors.affiliation: Phoniatrics and Paediatric Audiology Department, University Clinic of Cologne, Cologne, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lang-Roth
authors.affiliation: Department of Audiology, University Clinic of Giessen and Marburg, Marburg, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Wittekindt
authors.affiliation: Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery Department, University of Würzburg, Würzburg, Germany.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Hagen
authors.affiliation: Department of Otorhinolaryngology and Plastic Surgery, SRH Wald-Klinikum Gera, Gera, Germany.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Mueller
authors.affiliation: Department of Audiology and Phoniatrics, Charité-Medical University of Berlin, Berlin, Germany.
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Nasr
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Clinic of Jena, Jena, Germany.
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
authors.affiliation: ENT University Hospital Graz, Division of Phoniatrics, Medical University Graz, Graz, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Friedrich
authors.affiliation: ENT University Hospital Graz, Division of Phoniatrics, Medical University Graz, Graz, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Gugatschka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003679:Deglutition; D005260:Female; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012129:Respiratory Function Tests; D049489:Stroboscopy; D014826:Vocal Cord Paralysis / Q000601:surgery*; D014827:Vocal Cords / Q000601:surgery*; D014831:Voice; D014833:Voice Quality; D055815:Young Adult
keywords: Bilateral vocal fold paralysis; endoscopic surgery; respiratory outcomes; voice outcomes