편측 성대마비에서 자가지방을 이용한 성대주입술과 내전형 갑상성형술간의 음성학적 결과 비교
Comparison of Vocal Outcome after Autologous Fat Injection and Medialization Thyroplasty for Unilateral Vocal Cord Paralysis
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초록
Background and ObjectivesZZGlottic incompetence from the unilateral vocal cord paralysis can be improved by medialization of the paralyzed vocal cord. There are many medialization techniques. Among them, medialization thyroplasty and injection laryngoplasty are frequently used techniques. We compared the vocal outcomes of fat injection and medialization thyroplasty in unilateral vocal cord paralysis. The aim of this study is to find out which modalities are more preferable as initial treatment of unilateral vocal cord paralysis. Materials and MethodZZFrom 2004 January to 2008 September, medialization thyroplasty was performed in 13 patients and fat injection in 14 patients for unilateral vocal cord paralysis. We analyzed the voice quality by several subjective and objective parameters. The parameters are visual analog scale, GRBAS scale, acoustic analysis (fundamental frequency, jitter, shimmer,noise to harmonic ratio), and aerodynamic analysis (maximum phonation time, mean flow rate,subglottic pressure). ResultsZZVisual analog scale, jitter, shimmer and maximum phonation time are improved after both medialization thyroplsty and fat injection. In GRBAS scale, fat injection showed statistically significant improvement compared with medialization thyroplasty. The mean flow rate was also significantly decreased in fat injection. ConclusionZZBoth medialization thyroplasty and fat injection improved voice quality. But injection laryngoplasty with fat may be superior to silastic medialization in short-term voice outcome.
Abstract
Background and ObjectivesZZGlottic incompetence from the unilateral vocal cord paralysis can be improved by medialization of the paralyzed vocal cord. There are many medialization techniques. Among them, medialization thyroplasty and injection laryngoplasty are frequently used techniques. We compared the vocal outcomes of fat injection and medialization thyroplasty in unilateral vocal cord paralysis. The aim of this study is to find out which modalities are more preferable as initial treatment of unilateral vocal cord paralysis. Materials and MethodZZFrom 2004 January to 2008 September, medialization thyroplasty was performed in 13 patients and fat injection in 14 patients for unilateral vocal cord paralysis. We analyzed the voice quality by several subjective and objective parameters. The parameters are visual analog scale, GRBAS scale, acoustic analysis (fundamental frequency, jitter, shimmer,noise to harmonic ratio), and aerodynamic analysis (maximum phonation time, mean flow rate,subglottic pressure). ResultsZZVisual analog scale, jitter, shimmer and maximum phonation time are improved after both medialization thyroplsty and fat injection. In GRBAS scale, fat injection showed statistically significant improvement compared with medialization thyroplasty. The mean flow rate was also significantly decreased in fat injection. ConclusionZZBoth medialization thyroplasty and fat injection improved voice quality. But injection laryngoplasty with fat may be superior to silastic medialization in short-term voice outcome.
참고문헌 (13)
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