title: Longitudinal Voice Outcomes After Type I Gore-tex Thyroplasty for Nonparalytic Glottic Incompetence.
abstract: OBJECTIVE
  Type I Gore-tex thyroplasty (GTP) for nonparalytic glottic incompetence (GI) results in significantly improved subjective and perceptual voice outcomes. We endeavored to investigate the longitudinal course of voice outcomes measuring the same patients across time points stratified by diagnostic subgroup.
  
  
  METHODS
  Seventy-five patients with nonparalytic GI treated with GTP in the past 9 years were retrospectively reviewed and grouped according to their primary diagnoses (atrophy, scar, hypomobility, and paresis). Voice outcome measures, Voice-Related Quality of Life (VRQOL), Glottal Function Index (GFI), and GRBAS (grade, roughness, breathiness, asthenia, and strain) for each individual patient and diagnostic subgroup were grouped by time interval following surgery: 0 to 90 days, 3 to 9 months, 9 to 18 months, 18 to 36 months, 3 to 5 years, and 5 to 10 years.
  
  
  RESULTS
  Across all diagnoses, statistically significant improvement in VRQOL was maintained at 3 to 5 years (P = .03) and GFI at 5 to 10 years (P = .02). The GRBAS showed statistically significant improvements out to 18 to 36 months (P = .02). In the subgroup analysis, hypomobility/paresis patients maintained significant improvement voice measures longer than patients with other diagnoses. As a group, scar patients did not show statistically significant postoperative improvement in VRQOL or GFI at any of the tested time points.
  
  
  CONCLUSIONS
  Gore-tex thyroplasty provides durable improvement in subjective and perceptual voice outcomes for patients with nonparalytic GI. Patients treated for hypomobility/paresis have the most durable vocal outcomes followed by atrophy and lastly, scar.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
authors.forename: Lewis
authors.initials: L
authors.lastname: Overton
authors.affiliation: University of North Carolina at Chapel Hill School of Medicine, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Adams
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.
authors.forename: Rupali N
authors.initials: RN
authors.lastname: Shah
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA RBuckmir@unch.unc.edu.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Buckmire
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007818:Laryngeal Diseases / Q000601:surgery*; D058753:Laryngoplasty / Q000295:instrumentation* / Q000379:methods; D008297:Male; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012189:Retrospective Studies; D014833:Voice Quality
chemical_list: D011138:Polytetrafluoroethylene
keywords: Gore-tex medialization thyroplasty; Type I thyroplasty; glottic incompetence