Arytenoid Rotation and Nerve-Muscle Pedicle Transfer in Paralytic Dysphonia

作者：Hassan Megahed M; Yumoto Eiji^*; Baraka M Ali; Sanuki Tetsuji; Kodama Narihiro

来源：Laryngoscope, 2011, 121(5): 1018-1022.

DOI：10.1002/lary.21657

• Modified nerve-muscle pedicle flap transfer
• voice parameters
• unilateral vocal fold paralysis

Objectives/Hypothesis: Our objective was to evaluate the efficacy of modified nerve-muscle pedicle (NMP) flap transfer combined with arytenoid adduction (AA) (AA + modified NMP) for treatment of unilateral vocal fold paralysis. The patterns of voice outcome assessed using phonatory function tests and auditory perceptual judgments were followed-up for 2 years.
Study Design: Prospective study.
Methods: Thirteen subjects among those presented with paralytic dysphonia between March 2002 and December 2008 were treated with AA + modified NMP. The voice outcomes (six objective and two subjective voice parameters) were evaluated preoperatively and in four different time points postoperatively over 2-years duration.
Results: All voice parameters showed initial postoperative improvement. Moreover, five parameters showed significant continuous improvement over the 2-year follow-up (maximum phonation time, pitch range, shimmer, and grade overall and breathiness of the grade-roughness-breathiness-asthenia-strain scale (GRBAS), whereas two parameters revealed continuous improvement over the first 12 to 14 months after surgery (mean flow rate and harmonics-to-noise ratio).
Conclusions: AA + modified NMP improves both short- and long-term voice outcomes in unilateral vocal fold paralysis patients. Therefore, AA + modified NMP is an effective surgical combination for the treatment of severe paralytic dysphonia.

• 出版日期2011-5