Complications of type I thyroplasty and arytenoid adduction Journal Article
| Authors: | Abraham, M. T.; Gonen, M.; Kraus, D. H. |
| Article Title: | Complications of type I thyroplasty and arytenoid adduction |
| Abstract: | Objectives/Hypothesis: Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralyzed vocal fold but must be evaluated in light of potential complications following laryngeal framework surgery. Study Design and Methods: The charts of 237 patients who underwent unilateral vocal fold medialization surgery between July 1, 1991, and August 30, 1999, at a tertiary care cancer referral center were retrospectively reviewed. Results: There were 98 cases of type I thyroplasty alone and 96 cases of type I thyroplasty with arytenoid adduction. The two groups had similar patient characteristics. Mean time of surgery (45 vs. 73 min, P <.0001) and length of hospital stay (1.1 vs. 1.8 d, P <.0001) were increased when arytenoid adduction was performed. Overall improvement of symptoms was similar in both groups (93%-94%), but posterior glottic closure appeared subjectively improved when arytenoid adduction was used (P = .0054). Overall complication rates were slightly higher in the arytenoid adduction group (14% vs. 19%), primarily because of transient vocal fold edema and wound complications (9 vs. 19 cases), but the increase was not statistically significant (P = .1401). Complications warranting medical or surgical intervention occurred in 8% of cases. Two patients who underwent type I thyroplasty with arytenoid adduction required tracheotomy as a consequence of postoperative complications. The three patients who had extrusion of the implant underwent type I thyroplasty alone. Conclusion: Using the appropriate technique, the potential benefits of improved glottic function following type I thyroplasty with arytenoid adduction outweigh the small risk of significant complications observed. |
| Keywords: | adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; surgical technique; major clinical study; retrospective study; postoperative complication; length of stay; hospitalization; operation duration; complications; unilateral vocal fold paralysis; vocal cord paralysis; larynx surgery; prostheses and implants; oral surgical procedures; larynx edema; tracheotomy; humans; human; male; female; priority journal; article; arytenoid adduction; laryngeal framework surgery; vocal fold medialization; arytenoid cartilage; thyroid cartilage; phonosurgery; type i thyroplasty |
| Journal Title: | Laryngoscope |
| Volume: | 111 |
| Issue: | 8 |
| ISSN: | 0023-852X |
| Publisher: | Wiley Blackwell |
| Date Published: | 2001-08-01 |
| Start Page: | 1322 |
| End Page: | 1329 |
| Language: | English |
| PUBMED: | 11568563 |
| PROVIDER: | scopus |
| DOI: | 10.1097/00005537-200108000-00003 |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
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