Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.

Glottal insufficiency due to vocal fold paralysis, paresis, or atrophy often leads to degraded voice quality. One of the primary surgical intervention procedures to treat glottal insufficiency is medialization laryngoplasty, in which an implant is inserted through a lateral window on the thyroid car...

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Main Authors: Zhaoyan Zhang, Liang Wu, Raluca Gray, Dinesh K Chhetri
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0228464
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author Zhaoyan Zhang
Liang Wu
Raluca Gray
Dinesh K Chhetri
author_facet Zhaoyan Zhang
Liang Wu
Raluca Gray
Dinesh K Chhetri
author_sort Zhaoyan Zhang
collection DOAJ
description Glottal insufficiency due to vocal fold paralysis, paresis, or atrophy often leads to degraded voice quality. One of the primary surgical intervention procedures to treat glottal insufficiency is medialization laryngoplasty, in which an implant is inserted through a lateral window on the thyroid cartilage to medialize the vocal folds. While the goal of medialization is to modify the vocal fold structure to restore normal phonation, few studies have attempted to quantify such structural changes of the vocal folds. The goal of this study is to quantify the three-dimensional structural changes of the vocal folds due to implant insertion in medialization laryngoplasty, and evaluate its potential effect on voice production. Medialization laryngoplasty were performed in excised human larynges using implants of different stiffness. Magnetic resonance images of the larynges were obtained with and without implant insertion. The results showed that implant insertion significantly changed the original body-cover structure of the vocal folds, with the implant taking over the large space used to be occupied by the original body layer and the vocal fold being stretched into a thin layer wrapped around the implant. The medial-lateral dimension of the vocal fold was significantly reduced from about 4 mm to 1 mm, and the vocal fold was stretched in the coronal plane by about 70%. It is hypothesized that use of implants with stiffness comparable to that of the vocal folds is beneficial because the degree of medialization can be adjusted without much negative effects on phonation frequency, phonation threshold pressure, or vibration amplitude.
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spelling doaj.art-31b0a89c3c064999ab9b0aa9d8edafe92023-03-21T05:31:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01151e022846410.1371/journal.pone.0228464Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.Zhaoyan ZhangLiang WuRaluca GrayDinesh K ChhetriGlottal insufficiency due to vocal fold paralysis, paresis, or atrophy often leads to degraded voice quality. One of the primary surgical intervention procedures to treat glottal insufficiency is medialization laryngoplasty, in which an implant is inserted through a lateral window on the thyroid cartilage to medialize the vocal folds. While the goal of medialization is to modify the vocal fold structure to restore normal phonation, few studies have attempted to quantify such structural changes of the vocal folds. The goal of this study is to quantify the three-dimensional structural changes of the vocal folds due to implant insertion in medialization laryngoplasty, and evaluate its potential effect on voice production. Medialization laryngoplasty were performed in excised human larynges using implants of different stiffness. Magnetic resonance images of the larynges were obtained with and without implant insertion. The results showed that implant insertion significantly changed the original body-cover structure of the vocal folds, with the implant taking over the large space used to be occupied by the original body layer and the vocal fold being stretched into a thin layer wrapped around the implant. The medial-lateral dimension of the vocal fold was significantly reduced from about 4 mm to 1 mm, and the vocal fold was stretched in the coronal plane by about 70%. It is hypothesized that use of implants with stiffness comparable to that of the vocal folds is beneficial because the degree of medialization can be adjusted without much negative effects on phonation frequency, phonation threshold pressure, or vibration amplitude.https://doi.org/10.1371/journal.pone.0228464
spellingShingle Zhaoyan Zhang
Liang Wu
Raluca Gray
Dinesh K Chhetri
Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.
PLoS ONE
title Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.
title_full Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.
title_fullStr Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.
title_full_unstemmed Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.
title_short Three-dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty.
title_sort three dimensional vocal fold structural change due to implant insertion in medialization laryngoplasty
url https://doi.org/10.1371/journal.pone.0228464
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