2013 Volume 54 Issue 1 Pages 8-13
Vocal fold (VF) injection, thyroplasty type I and arytenoid adduction (AA) are common treatments for breathy dysphonia due to unilateral VF paralysis (UVFP). However, some patients do not recover their normal voices following these procedures. Theoretically, reinnervation of the thyroarytenoid (TA) muscle is the ideal treatment for UVFP. Normal voice production requires optimal closure of the glottis with median location of the VFs, symmetrical VF tension and mass, and supple mucosa. In the present study, we evaluated the long-term efficacy of AA combined ansa cervicalis-recurrent laryngeal nerve anastomosis (ACN-RLN) in the treatment of UVFP. Eight patients with severe paralytic dysphonia with large glottic gap were included. Vocal outcome was followed up over 24 months to evaluate the long-term efficacy of this combined procedure. Videostroboscopy, aerodynamic analysis, acoustic analysis, and perceptual voice quality were evaluated preoperatively and postoperatively at 1, 3, 6, 12 and 24 months. All parameters improved significantly after surgery and continued to improve over the 24-month period. Treatment with AA+ACN-RLN provided near-normal vocal function in the 24-month follow-up. Therefore, this method could be a successful surgical treatment for severe paralytic dysphonia.
