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J Korean Soc Laryngol Phoniatr Logop > Volume 28(2); 2017 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2017;28(2): 118-122.
doi: https://doi.org/10.22469/jkslp.2017.28.2.118
일측성 성대마비 환자에서 내전형 갑상성형술, 피열연골 내전술, 피열연골내전술과 성대주입술 병행치료의 음성 결과 비교
진호경1, 원성준2, 최나연3, 손영익1
1성균관대학교 의과대학 삼성서울병원 이비인후과학교실
2경상대학교 의과대학 이비인후과학교실
3국군수도병원 이비인후과학교실
Comparison of Voice Outcomes between Medialization Thyroplasty and Arytenoid Adduction with or without Injection Laryngoplasty in Unilateral Vocal Fold Paralysis Patients
Hokyung Jin1, Seong Jun Won2, Nayeon Choi3, Young-Ik Son1
1Department of Otorhinolaryngology-Head & Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
2Department of Otorhinolaryngology-Head & Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
3Department of Otorhinolaryngology-Head & Neck Surgery, The Armed Force Capital Hospital, Sungnam, Korea
Correspondence  Young-Ik Son ,Tel: (02) 3410-3579, Fax: (02) 3410-3879, Email: yison@skku.edu
Received: 12 November 2017; Revised: November 16, 2017   Accepted: 23 November 2017.  Published online: 31 December 2017.
Background and Objectives
In unilateral vocal fold paralysis (VFP), medialization thyroplasty (MT), arytenoid adduction (AA) and injection layrngoplasty (IL) are the most common procedures to correct phonatory problems. There is no consensus that which procedure is superior to the other for correcting the glottal insufficiency. The purpose of this study was to compare the phonatory parameters between MT, AA and AA with IL (AA+IL) in patients with unilateral VFP.
Materials and Methods
This retrospective study enrolled patients from 2005 to 2016. Total 72 patients (49 male, 23 female, mean age 54.5 years) were classified into three groups ; MT (n=28), AA (n=12), and AA+IL (n=32). GRBAS scales, maximum phonation time (MPT), jitter, shimmer, noise to harmonic ratio (NHR), and voice handicap index (VHI)-10 and VHI-30 were preoperatively and postoperatively collected and compared between the three groups.
Age, gender and cause of VFP were not significantly different between the three groups. In MT and AA groups, MPT, VHI, G (overall grade) and B (breathiness) were significantly improved. In AA+IL group, jitter, shimmer, NHR, MPT, VHI, G and B were significantly improved. In analysis of differences (pre-postoperative values), Δ jitter (p<0.001), Δ shimmer (p=0.031), and Δ NHR (p=0.002) were significantly different and AA+IL group showed the greatest improvement.
Analysis of voice parameters showed that all the three procedures for patients with unilateral VFP are effective in the improvement of voice ; especially in MPT, VHI-10, G and B scales. Compared to the others, AA+IL provided the better acoustic values including jitter, shimmer and NHR.
KEY WORDS: Medialization thyroplastyArytenoid adductionInjection laryngoplastyUnilateral vocal fold paralysisVoice parameters
중심 단어: 내전형 갑상성형술피열연골내전술후두주입술 음성 지표
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