title: Management of Posterior Glottal Insufficiency With Use of a Buccal Graft.
abstract: OBJECTIVE
  Posterior glottal insufficiency manifests as a rough, breathy voice with poor vocal projection, air hunger, and decreased phonatory efficiency. There are limited medical and surgical therapies. This study reports the use of insetting a buccal mucosa graft into the posterior interarytenoid space to close the posterior glottic gap for phonatory rehabilitation.
  
  
  METHODS
  Our study is a retrospective case series of 2 female patients undergoing buccal mucosa graft inset to repair acquired posterior glottic insufficiency as a result of prolonged intubation and laryngeal tuberculosis infection. Patients selected for this procedure had posterior glottal insufficiency due to erosion of posterior glottal tissue. They also had dysphonia refractory to voice therapy and injection augmentation.
  
  
  CONCLUSIONS
  Interarytenoid buccal graft for posterior glottal insufficiency is effective with excellent vocal rehabilitation and minimal donor site morbidity.
authors.affiliation: 1 Department of Otolaryngology/Head and Neck Surgery, New York Eye and Ear Infirmary-Mount Sinai Health System, New York, New York, USA.
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Helman
authors.affiliation: 1 Department of Otolaryngology/Head and Neck Surgery, New York Eye and Ear Infirmary-Mount Sinai Health System, New York, New York, USA.
authors.forename: William
authors.initials: W
authors.lastname: Karle
authors.affiliation: 2 Voice and Swallowing Institute, Department of Otolaryngology/Head and Neck Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Pitman
mesh_terms: D001193:Arytenoid Cartilage / Q000473:pathology; D055154:Dysphonia / Q000209:etiology / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D009336:Necrosis; D012189:Retrospective Studies; D049489:Stroboscopy; D055815:Young Adult
keywords: intubation trauma; laryngology; miscellaneous; otolaryngology; voice; voice quality; voice recovery