Laryngology

Arytenoid rotation and nerve-muscle pedicle transfer in paralytic dysphonia †

  1. Megahed M. Hassan MD1,
  2. Eiji Yumoto MD2,*,
  3. M. Ali Baraka MD3,
  4. Tetsuji Sanuki MD2,
  5. Narihiro Kodama BA2

Article first published online: 25 APR 2011

DOI: 10.1002/lary.21657

Issue

The Laryngoscope

The Laryngoscope

Volume 121, Issue 5, pages 1018–1022, May 2011

Additional Information

How to Cite

Hassan, M. M., Yumoto, E., Ali Baraka, M., Sanuki, T. and Kodama, N. (2011), Arytenoid rotation and nerve-muscle pedicle transfer in paralytic dysphonia . The Laryngoscope, 121: 1018–1022. doi: 10.1002/lary.21657

Author Information

  1. 1

    Unit of Phoniatrics–Department of Otolaryngology , Faculty of Medicine, Sohag University, Sohag, Egypt

  2. 2

    Department of Otolaryngology–Head and Neck Surgery , Graduate School of Medicine, Kumamoto University, Kumamoto, Japan

  3. 3

    Unit of Phoniatrics–Department of Otolaryngology , Faculty of Medicine, Ain Shams University, Cairo, Egypt

*Department of Otolaryngology–Head and Neck Surgery, Graduate School of Medicine Kumamoto University, 1-1-1 Honjo, Kumamoto, Japan 860-8556

  1. †

    The authors have no funding, financial relationships, or conflicts of interest to disclose.

Publication History

  1. Issue published online: 25 APR 2011
  2. Article first published online: 25 APR 2011
  3. Manuscript Accepted: 9 DEC 2010
  4. Manuscript Revised: 8 DEC 2010
  5. Manuscript Received: 5 NOV 2010

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Keywords:

  • Modified nerve-muscle pedicle flap transfer;
  • voice parameters;
  • unilateral vocal fold paralysis;
  • Level of Evidence: 2c.

Abstract

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.

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