Details

Autor(en) / Beteiligte

• Liu, Kuo‐Cheng
• Lu, Yi‐An
• Chuang, Hsiu‐Feng
• Hsin, Li‐Jen
• Lin, Wan‐Ni
• Wong, Alice M. K.
• Pei, Yu‐Cheng
• Fang, Tuan‐Jen

Titel

Persistence of lower vocal intensity in vocal fold paralysis with cricothyroid impairment after hyaluronate injection

Ist Teil von

• Laryngoscope investigative otolaryngology, 2022-12, Vol.7 (6), p.1922-1929

Ort / Verlag

Hoboken, USA: John Wiley & Sons, Inc

Erscheinungsjahr

2022

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Background Unilateral vocal fold paralysis (UVFP) affects the glottal gap, voice, and aerodynamics, whereas injection laryngoplasty (IL) using hyaluronate is an effective treatment for UVFP by decreasing the glottal gap to improve voice. Previous studies have shown that the involvement of cricothyroid (CT) muscle in UVFP patients further affects patients' aerodynamics, but it remains unclear whether the difference remains after IL. This study investigates whether the aerodynamic features observed in UVFP with CT involvement could still be observed after IL. Methods This study recruited UVFP patients with dysphonia, and IL was performed within 6 months of initial symptoms. All subjects received assessments including videolaryngoscopy, voice analysis, and aerodynamics at three time points: before IL, 1 month after IL, and 6 months after IL. The glottal gap, voice, and aerodynamics between patients with and without CT involvement (the CT+ and CT− groups) were compared, and the change (Δ) before and after IL and repeated‐measures analysis of variance (ANOVA) were also compared between the two groups. Result A total of 71 patients with UVFP (22 in the CT+ group and 49 in the CT− group) were analyzed. After IL, the CT+ group showed a lower sound pressure level (SPL), higher Δair pressure, and smaller Δaerodynamic power than the CT− group. Conclusion The CT+ group had a lower SPL, even after elevating air pressure to attempt to achieve a higher vocal intensity. The results suggest that although closure of the glottal gap was achieved by IL, the CT+ group still had a lower loudness and needed to sustain a higher peak air pressure when producing voice. Level of evidence Level 4. A poorer long‐term prognosis was observed in UVFP patients with cricothyroid (CT) muscle involvement than those without CT muscle involvement, even after injection laryngoplasty (IL). Although closure of the glottal gap was achieved by IL, UVFP patients with CT muscle involvement still had a lower loudness and needed to sustain a higher peak air pressure when producing voice. Longer post‐injection follow‐up and early speech language pathologist referral are necessary in UVFP with CT dysfunction.