Nonparalytic glottic incompetence (GI) encompasses a variety of laryngeal pathologies, and vocal outcome data for this group is limited. We report a subgroup analysis of validated, subjective, and perceptual voice outcome measures: voice-related quality of life (VRQOL), Glottal Function Index (GFI), and GRBAS (grade, roughness, breathiness, asthenia, and strain), after type I Gore-Tex thyroplasty (GTP) in patients with vocal fold paresis (VFP), hypomobility, scar, and atrophy.
Forty-eight patients with nonparalytic GI treated with GTP were reviewed. Patients were grouped according to primary diagnosis: VFP (n=12), hypomobility (n=20), scar (n=7), and atrophy (n=9). Voice outcome measures (VRQOL, GFI, and GRBAS) obtained during the initial evaluation and the most recent follow-up were collected and analyzed.
The median change in VRQOL was significant for each subgroup (all P<.03). Hypomobility and VFP patients demonstrated significantly improved GFI scores postoperatively (P=.0002 and .008, respectively); atrophy and scar groups did not. All groups, with the exception of scar patients (P=.13), showed significant improvement in perceptual scores. Increases in VRQOL moderately correlated with decreases in GFI (rho=−0.52).
Regardless of etiology, patients with nonparalytic GI demonstrated improved subjective and perceptual measures following GTP. Although showing trends toward improvement, vocal fold scar patients performed worse than all other subgroups across all three voice outcome measures.
Level of Evidence
4. Laryngoscope, 2013