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Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis

Published online by Cambridge University Press:  25 November 2010

J Shi ,
S Chen ,
D Chen ,
W Wang ,
S Xia  and
H Zheng
J Shi
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
S Chen
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
D Chen
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
W Wang
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
S Xia
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
H Zheng*
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
*
Address for correspondence: Dr Hongliang Zheng, Department of Otorhinolaryngology–Head and Neck Surgery, Changhai Hospital, Second Military Medical University, Changhai Road 168, Shanghai 200433, China Fax: +86 21 65335025 E-mail: zheng_hl2004@163.com
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Abstract

Objectives:

(1) To evaluate the efficacy of modified arytenoid adduction in the management of patients with symptomatic cancer-related unilateral vocal fold paralysis, and (2) to assess the impact of this treatment on patients' quality of life.

Methods:

Forty-two patients with cancer-related unilateral vocal fold paralysis underwent modified arytenoid adduction between February 2001 and December 2008. Of these, 37 patients were enrolled in this retrospective study (one patient died of primary disease and four were lost to follow up). Laryngostroboscopy was performed to evaluate vocal fold orientation and mobility. Pre- and post-operative assessment of subjective and objective voice, aerodynamic parameters, and quality of life were also undertaken, and aspiration was subjectively rated.

Results:

Laryngostroboscopic findings indicated a significant post-operative improvement in vocal fold posterior glottal closure and vertical gap. Significant improvements in voice quality, aerodynamic parameters and quality of life were noted three months post-operatively in all patients (p < 0.01). The overall success rate for swallowing rehabilitation was 94.6 per cent (35/37). Subjective aspiration ratings decreased significantly post-operatively, compared with pre-operative values (p < 0.01). No major complication occurred in any patient, except for dyspnoea in one patient.

Conclusion:

Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.

Keywords

Vocal Fold ParalysisHead and Neck NeoplasmsSurgeryQuality of Life
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 2 , February 2011 , pp. 173 - 180
Copyright
Copyright © JLO (1984) Limited 2010

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