COMPARISON OF LATERALIZATION THYROPLASTY AND LASER CORD WEDGE RESECTION IN TERMS OF VOICE QUALITY IN PATIENTS WITH BILATERAL ABDUCTOR VOCAL CORD PARALYSIS

Year 2019, Volume: 9 Issue: 4, 343 - 348, 31.12.2019

Dursun Tuzun Yusufhan Suoglu Mustafa Sitki Gozeler

https://doi.org/10.16899/jcm.625978

Abstract

Abstract

Background/Aims: It was aimed to compare
lateralization thyroplasty with laser cord wedge resection in terms of
postoperative voice analysis, duration of hospital stay, tracheotomy rate, and
decannulation time in patients with
bilateral abductor vocal cord paralysis. 

Methods: A
total of 37 patients who presented to our department with bilateral abductor
vocal cord paralysis between February 2005 and February 2009 were enrolled in
this prospective study. External
arytenoid lateralization (lateralization thyroplasty) was randomly performed in
22 patients and laser posterior cordotomy was performed in 15 patients. Fifteen
healthy volunteers were assigned to the control group. Postoperative 6^th
month maximum phonation time (MPT), S/Z ratio, and the results of objective
voice analysis [mean frequency perturbation (jitter), mean amplitude
perturbation (shimmer), mean fundamental frequency (fo), and NHR (noise to
harmonic ratio)] were compared between the two groups and the control group.
Decannulation time, patient tracheotomy status, and duration of hospital stay
were also recorded.

Results: The mean
postoperative MPT decreased but S/Z ratio increased in both patient groups
compared to the control group. The mean MPT was shorter in the external
arytenoid lateralization group versus the laser posterior cordotomy group (p= 0.011).
There was no statistically significant difference between the external
arytenoid lateralization and laser posterior cordotomy groups in terms of mean
S/Z ratio (p= 0.306). It was observed that jitter, shimmer, and NHR values were
increased, i.e. voice quality impaired, in both patient groups. Jitter (p= 0.004),
shimmer (p<0.001), and NHR (p= 0.052) values were significantly increased in
the laser posterior cordotomy group as compared with the external arytenoid
lateralization group. No statistically significant difference was found between
the external arytenoid lateralization group and the laser posterior cordotomy
group in terms of the mean postoperative f(o) (p= 0.417), as well as for
decannulation time (p= 0.076) and duration of hospital stay (p= 2.30).

Conclusions: External arytenoid
lateralization is a more preferable technique than laser posterior cordotomy because
it preserves mucosal integrity and cord mass, which results in better voice
quality.

Keywords

Lateralization Thyroplasty, Laser cordectomy, jitter, shimmer

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