COMPARISON OF LATERALIZATION THYROPLASTY AND LASER CORD WEDGE RESECTION IN TERMS OF VOICE QUALITY IN PATIENTS WITH BILATERAL ABDUCTOR VOCAL CORD PARALYSIS

Authors : Dursun TUZUN, Yusufhan SUOGLU, Mustafa Sitki GOZELER

Pages : 343-348

Doi:10.16899/jcm.625978

View : 17 | Download : 5

Publication Date : 2019-12-31

Article Type : Research Paper

Abstract :Abstract Background/Aims:  It was aimed to compare lateralization thyroplasty with laser cord wedge resection in terms of postoperative voice analysis, duration of hospital stay, tracheotomy rate, and decannulation time in patients with bilateral abductor vocal cord paralysis.  Methods:  A total of 37 patients who presented to our department with bilateral abductor vocal cord paralysis between February 2005 and February 2009 were enrolled in this prospective study . External arytenoid lateralization insert ignore into journalissuearticles values(lateralization thyroplasty); was randomly performed in 22 patients and laser posterior cordotomy was performed in 15 patients. Fifteen healthy volunteers were assigned to the control group. Postoperative 6 th month maximum phonation time insert ignore into journalissuearticles values(MPT);, S/Z ratio, and the results of objective voice analysis [mean frequency perturbation insert ignore into journalissuearticles values(jitter);, mean amplitude perturbation insert ignore into journalissuearticles values(shimmer);, mean fundamental frequency insert ignore into journalissuearticles values(fo);, and NHR insert ignore into journalissuearticles values(noise to harmonic ratio);] were compared between the two groups and the control group. Decannulation time, patient tracheotomy status, and duration of hospital stay were also recorded. Results:  The mean postoperative MPT decreased but S/Z ratio increased in both patient groups compared to the control group. The mean MPT was shorter in the external arytenoid lateralization group versus the laser posterior cordotomy group insert ignore into journalissuearticles values(p= 0.011);. There was no statistically significant difference between the external arytenoid lateralization and laser posterior cordotomy groups in terms of mean S/Z ratio insert ignore into journalissuearticles values(p= 0.306);. It was observed that jitter, shimmer, and NHR values were increased, i.e. voice quality impaired, in both patient groups. Jitter insert ignore into journalissuearticles values(p= 0.004);, shimmer insert ignore into journalissuearticles values(p<0.001);, and NHR insert ignore into journalissuearticles values(p= 0.052); values were significantly increased in the laser posterior cordotomy group as compared with the external arytenoid lateralization group. No statistically significant difference was found between the external arytenoid lateralization group and the laser posterior cordotomy group in terms of the mean postoperative finsert ignore into journalissuearticles values(o); insert ignore into journalissuearticles values(p= 0.417);, as well as for decannulation time insert ignore into journalissuearticles values(p= 0.076); and duration of hospital stay insert ignore into journalissuearticles values(p= 2.30);. Conclusions:  External arytenoid lateralization is a more preferable technique than laser posterior cordotomy because it preserves mucosal integrity and cord mass, which results in better voice quality.
Keywords : Lateralization Thyroplasty, Laser cordectomy, jitter, shimmer