Humans ; Injections ; Laryngoplasty ; methods ; trends ; Vocal Cords

OBJECTIVEThe aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome.

METHODSSix patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.

RESULTSNasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment.

CONCLUSIONSThe combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.

Humans ; Hyoid Bone ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Laryngoplasty ; methods ; Larynx ; surgery ; Surgical Flaps

At present, there is no unified gold standard for the treatment of laryngeal clefts. Type Ⅰ laryngeal clefts with mild symptoms can be treated conservatively, such as thick diet feeding and using proton pump inhibitor to control reflux, while Ⅱ-Ⅳ laryngeal clefts mostly requires surgical intervention.There are many different surgical methods for the treatment of laryngeal clefts, including injection laryngoplasty, endoscopic surgical repair of laryngeal clefts and open laryngoplasty through anterior cervical approach. How to choose a more suitable surgical plan for children is a problem worth discussing. This article will review the literature on the surgical treatment of laryngeal clefts both domestically and internationally, and summarize the current situation and challenges of surgical treatment of laryngeal clefts.
Child ; Humans ; Congenital Abnormalities/surgery* ; Endoscopy ; Laryngoplasty/methods* ; Laryngoscopy/methods* ; Larynx/surgery*

OBJECTIVES: The purpose of this study was to explore the effects of injection laryngoplasty (IL) with hyaluronic acid in patients with vocal fold paralysis (VFP). METHODS: A total of 50 patients with VFP participated in this study. Pre- and post-IL assessments were performed, which included analyzing the sustained vowel /a/ phonation, and the patient reading 1 Korean sentence from the “Walk” passage that comprised 25 syllables in 10 words. To investigate the effect of IL on vocal fold function, acoustic analysis (acoustic voice quality index, cepstral peak prominence, maximum phonation time, speaking fundamental frequency) was conducted and auditory-perceptual (grade and overall severity), visual judgment (gap), and self-questionnaire (voice handicap index-10) assessments were performed. RESULTS: The patients with VFP showed statistically significant differences between pre-and post-IL assessments for acoustic and auditory-perception, visual judgment, and self-questionnaire assessments. CONCLUSION: The patients with VFP showed positive change in vocal fold function between pre- and post-IL measurements. The findings showed that IL with hyaluronic acid is an effective method to improve vocal fold function in patients with VFP.
Acoustics ; Humans ; Hyaluronic Acid* ; Judgment ; Laryngoplasty* ; Methods ; Paralysis* ; Phonation ; Vocal Cords* ; Voice Quality

PURPOSE: To overcome the potential disadvantages of the use of foreign materials and autologous fat or collagen, we introduce here an autologous plasma gel for injection laryngoplasty. The purpose of this study was to present a new injection material, a plasma gel, and to discuss its clinical effectiveness. MATERIALS AND METHODS: From 2 mL of blood, the platelet poor serum layer was collected and heated at 100degrees C for 12 min to form a plasma gel. The plasma gel was then injected into a targeted site; the safety and efficacy thereof were evaluated in 30 rats. We also conducted a phase I/II clinical study of plasma gel injection laryngoplasty in 11 unilateral vocal fold paralysis patients. RESULTS: The plasma gel was semi-solid and an easily injectable material. Of note, plasma gel maintains the same consistency for up to 1 year in a sealed bottle. However, exposure to room air causes the plasma gel to disappear within 1 month. In our animal study, the autologous plasma gel remained in situ for 6 months in animals with minimal inflammation. Clinical study showed that vocal cord palsy was well compensated for with the plasma gel in all patients at two months after injection with no significant complications. Jitter, shimmer, maximum, maximum phonation time (MPT) and mean voice handicap index (VHI) also improved significantly after plasma gel injection. However, because the injected plasma gel was gradually absorbed, 6 patients needed another injection, while the gel remained in place in 2 patients. CONCLUSION: Injection laryngoplasty with autologous plasma gel may be a useful and safe treatment option for temporary vocal cord palsy.
Adult ; Aged ; Aged, 80 and over ; Animals ; *Blood Platelets ; Female ; Humans ; Laryngoplasty/*methods ; Male ; Middle Aged ; Plasma/*physiology ; Rats

OBJECTIVETo observe the result of relaxation laryngoplasty in the management of mutational falsetto.

METHODSThe thyroplasty type 3 was applied and improved (the saturation was improved in the traditional operation, which the thyroid cartilage stick was cut off and overlapped without saturation in improved group 1, while the thyroid cartilage stick was not cut off and overlapped inward without saturation in improved group 2) in 30 adult patients who failed in voice modification. Preoperative and postoperative fundamental frequency (F0), normalised noise energy (NNE) and reading essay were compared.

RESULTSF0 dropped significantly from the preoperative mean of (276.5 +/- 46.7) Hz [see equation in text] to the postoperative mean of (127.5 +/- 32.1) Hz in one month (t = 13.68, P < 0.001), while the NNE dropped significantly from the preoperative mean of (-10.9 +/- 4.9) dB to the postoperative mean of (-7.7 +/- 4.1) dB, the difference was statistically significant (t = 4.07, P < 0.001). In the three kinds of operation, the postoperative F0 in the improved group 1 dropped most significantly (compared with traditional operation group t = 2.64, P< 0.05). The postoperative NNE in the improved group 2 increased minimally. The difference was not significant statistically compared with other two kinds of operations (P > 0.05). The pitch dropped in all cases during reading aloud and conversation, while the voice breaks was disappeared.

CONCLUSIONSRelaxation laryngoplasty was proved to be an efficient procedure in the surgical management of mutational falsetto.It was a preferable option for the patients who failed in voice modification. The improved operation profited to recover natural intonation and lighten the hoarseness due to glottic incompetence.

Adolescent ; Adult ; Humans ; Laryngoplasty ; methods ; Larynx ; surgery ; Male ; Thyroid Cartilage ; surgery ; Voice Disorders ; surgery ; Voice Quality ; Young Adult

BACKGROUND AND OBJECTIVES: Radiesse® is a widely used calcium hydroxyapatite (CaHA) injection material used for vocal fold injection. Recently, a new CaHA injection material (Facetem ®) which complements the structural disadvantages of Radiesse has been developed and released in the market. The aim of this study is to compare the efficacy and short-term voice outcome of these two CaHA materials. SUBJECTS AND METHOD: A retrospective analysis was performed for 70 patients with unilateral vocal fold paralysis who underwent vocal fold injection using CaHA materials. Acoustic voice analysis, maximal phonation time (MPT), voice handicap index (VHI), and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale were evaluated between Radiesse and Facetem injection group. RESULTS: Both groups showed a signifcant improvement of MPT, VHI, and G, B, A scale after injection. The Facetem group showed similar voice improvement as the Radiesse group, where pre- and postoperatively objective and subjective voice evaluation results were compared. CONCLUSION: Our study reveals that there is no significant difference in efficacy and nor any short-term vocal improvement between Radiesse and Facetem. Therefore, the use of Facetem as CaHA injection material could be considered as an alternative material for patients with unilateral vocal cord paralysis.
Acoustics ; Asthenia ; Calcium ; Complement System Proteins ; Durapatite ; Humans ; Laryngoplasty ; Methods ; Paralysis ; Phonation ; Retrospective Studies ; Vocal Cord Paralysis ; Vocal Cords ; Voice

BACKGROUND AND OBJECTIVES: The purpose of this study was to classify patients with unilateral vocal fold paralysis according to their fixed location and to analysis the effects of two treatment methods by early voice therapy and injection laryngoplasty. MATERIALS AND METHODS: Twenty patients who were classified as full abduction and slight abduction according to the position of paralysis were treated injection laryngoplasy, and 23 patients were treated by voice therapy. Twenty patients were treated injection laryngoplasy and 23 patients were treated voice therapy. Results were evaluated by acoustic analysis, electroglottography, cepstrum analysis before and after therapy. The voice therapy was conducted by improving the larynx movement and glottal contact, whilst removing hypertension of the supraglottic and use the breathing. RESULTS: Significant improvement was found in the acoustic parameter, cepstrum parameter, and EGG before and after treatment in both groups. There was no significant difference between the two groups when compared before and after treatment to compare the effects of injection laryngoplasty and voice therapy. CONCLUSION: The initial treatments for unilateral vocal cord paralysis are injection laryngoplasty and voice therapy. however, there is no precise standard about which method should be applied first. Therefore, in this study, we tried to classify patients according to their paralysis position and then apply two methods. The results of this study suggest that voice therapy and Injection laryngoplasty at the initial stage is a very useful method to improve voice quality of vocal fold paralysis and improve laryngeal function.
Acoustics ; Humans ; Hypertension ; Laryngoplasty* ; Larynx ; Methods ; Ovum ; Paralysis ; Respiration ; Speech Therapy ; Therapeutic Uses* ; Vocal Cord Paralysis* ; Vocal Cords ; Voice Quality ; Voice*

BACKGROUND AND OBJECTIVES: The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. MATERIALS AND METHOD: 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. RESULTS: In GRBAS scale, G (p < 0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p < 0.001, p < 0.001 p=0.003, p < 0.001, and p < 0.001 respectively). CONCLUSION: From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.
Acoustics ; Deglutition ; Enteral Nutrition ; Humans ; Hyaluronic Acid ; Laryngoplasty ; Methods ; Palliative Care ; Phonation ; Pneumonia, Aspiration ; Quality of Life ; Vocal Cord Paralysis ; Voice ; Voice Quality