Arytenoid adduction combined with nerve-muscle pedicle flap implantation or type I thyroplasty.

OBJECTIVES/HYPOTHESIS: To evaluate vocal function after refined nerve-muscle pedicle (NMP) flap implantation with arytenoid adduction (AA) compared with type I thyroplasty with AA for patients with unilateral vocal fold paralysis (UVFP) and to evaluate the degree of patient satisfaction following the refined NMP with AA.

STUDY DESIGN: A retrospective review of clinical records of 52 patients with UVFP who received AA + NMP (NMP group, n = 40) or AA + type I thyroplasty (type I group, n = 12) as a single-stage operation between April 1999 and December 2011.

METHODS: Evaluation of vocal fold vibration, aerodynamic analysis, perceptual evaluation, acoustic analysis, and subjective assessment were performed preoperatively and at two different postoperative periods (short term: within 3 months and long term: >12 months).

RESULTS: All parameters except for glottal gap of the vocal fold vibration, maximum phonation time (MPT), and mean airflow rate revealed significant improvement between the short- and long-term assessments in the NMP group. On the contrary, the type I group did not show significant change of any parameters during postoperative periods. In the NMP group, the measurements for regularity of the vocal fold vibration and MPT at the long-term assessment were significantly favorable compared with the type I group. In the NMP group, subjective assessment (Voice Handicap Index-10 and Voice-Related Quality of Life) revealed significant improvement between the short- and long-term assessments.

CONCLUSIONS: In comparison with the type I group, significant improvement of vocal function patient satisfaction during the long-term follow-up period after AA combined with the refined NMP was confirmed.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:159-166, 2017.