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J Korean Soc Laryngol Phoniatr Logop > Volume 14(2); 2003 > Article
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics 2003;14(2): 117-122.
미리 제작된 Hydroxylapatite 보형물을(VoCoM$^{circledR}$) 이용한 제 1 형 갑상성형술
이현종, 정한신, 백정환, 손영익
성균관대학교 의과대학 삼성서울병원 이비인후과학교실
Type I Thyroplasty Using Prefabricated Hydroxylapatite Implant(VoCoM$^{circledR}$)
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ABSTRACT
Background and Objectives
: $VoCoM^{circledR}$ is a commercialized set composed of prefabricated hydroxylapatite implants and shims of various sizes which are specially designed for the type I thyroplasty. Even though a previously published preliminary report showed that $VoCoM^{circledR}$ is a convenient and safe product for the type I thyroplasty, further investigations or experiences are yet to be reported. Authors aimed to evaluate the efficacy of $VoCoM^{circledR}$type I thyroplasty, and its advantage and/or disadvantage.
Materials and Method
: Twenty three consecutive patients with unilateral vocal cord palsy enrolled for the study, who received type I thyroplasty with $VoCoM^{circledR}$ between July 2001 and June 2003. Acoustic, aerodynamic and stoboscopic analyses were performed prior to surgery and 1 to 3 months after surgery. Speech language pathologists evaluated their voice quality by GRBAS scale, and patients themselves reported subjective changes of their voice by visual analog scale.
Results
: The average time for the operation was 80 min, which is about 30 min less than other methods. Preoperative jitter was 3.25$pm$1.65% and improved to 1.94$pm$1.79% postoperatively (p<0.05). Preoperative shimmer was 9.72$pm$6.56% and improved to 5.61 $pm$3.76% (p<0.05), Maximal phonation time increased from 4.41$pm$2.99 to 7.98$pm$4.35 sec (p<0.05) The postoperative stroboscopy revealed an effective medialization in 91.3% of the patients. The subjective phonetic improvements were reported in 21 out of 23 patients. GRBAS scale improved from 2.71$pm$0.46 to 1.47$pm$1.12(p<0.05). Additional medialization with $Gore-Tex^{circledR}$ was easily performed in two revision cases. Previously inserted $VoCoM^{circledR}$ implant was hard to remove because of the tight integration of soft tissues around the implant. Side effects such as extrusion or foreign body reaction are not observed. $VoCoM^{circledR}$ was relatively expensive and costed more than 10 times of $Gore-Tex^{circledR}$.
Conclusion
: Prefabricated hydroxylapatitie implant($VoCoM^{circledR}$) provides a convenient, safe and efficient way of vocal fold medialization. However it is relatively expensive and hard to remove.
KEY WORDS: Hydroxylapatite implant;Vocal cord palsy;Prosthesis;Hydroxylapatite;Surgery;Type I thyroplasty;
중심 단어: 일측성 성대마비;제1형 갑상성형술;
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