Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia

Abstract Objective Compare long‐term voice outcomes in patients treated with FIM or BML for nonparalytic dysphonia. There is controversy whether fat injection medialization (FIM) is a durable alternative to bilateral medialization laryngoplasty (BML) for nonparalytic dysphonia (atrophy, sulcus, scar...

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Main Authors: Sarah K. Rapoport, Thomas Murry, Peak Woo
Format: Article
Language:English
Published: Wiley 2021-06-01
Series:Laryngoscope Investigative Otolaryngology
Subjects:
Online Access:https://doi.org/10.1002/lio2.573
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author Sarah K. Rapoport
Thomas Murry
Peak Woo
author_facet Sarah K. Rapoport
Thomas Murry
Peak Woo
author_sort Sarah K. Rapoport
collection DOAJ
description Abstract Objective Compare long‐term voice outcomes in patients treated with FIM or BML for nonparalytic dysphonia. There is controversy whether fat injection medialization (FIM) is a durable alternative to bilateral medialization laryngoplasty (BML) for nonparalytic dysphonia (atrophy, sulcus, scar, paresis). Both interventions yield improved voice quality, yet comparison of patients' long‐term perceptions of their voice after these procedures has not been performed. Methods Retrospective review of patients who underwent FIM or BML for nonparalytic dysphonia was performed from 2008‐2018. Charts were reviewed for demographic information, preoperative diagnosis, intervention, Voice Handicap Index‐10 (VHI‐10), and follow‐up time. Results Forty‐nine patients met our criteria. Fifty procedures were performed (25 FIM, 25 BML). One patient underwent BML with subsequent FIM. There was no significant difference in pre‐treatment or post‐treatment VHI‐10 scores between both groups (Pre‐FIM 21 Post‐FIM 10.28; Pre‐BML 22.48, Post‐BML 10.88). Total median follow‐up time was 11.3 months (FIM 14.8 months, BML 9.5 months). Using VHI‐10 scores recorded at each patient's latest follow‐up visit, both groups demonstrated significant decrease (P < .05) compared to preoperative scores: VHI‐10 decreased by a mean delta of 10.72 in the FIM group and 11.6 in the BML group. There was no significant difference in pre, post and change in VHI between groups. Conclusions In patients with nonparalytic dysphonia, FIM is a durable alternative to BML. Patients treated in both groups gained substantial improvement in vocal function. For both treatment groups, we should anticipate less than complete satisfaction with surgery and revision procedures in a minority of patients. Level of Evidence IV.
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spelling doaj.art-ab939b97829f42c08f158b081032b3b72022-12-21T18:57:02ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-06-016345345710.1002/lio2.573Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphoniaSarah K. Rapoport0Thomas Murry1Peak Woo2Department of Otolaryngology Head and Neck Surgery Mount Sinai Medical Center New York New York USADepartment of Otolaryngology‐Head and Neck Surgery Loma Linda Health University Loma Linda California USADepartment of Otolaryngology Head and Neck Surgery Mount Sinai Medical Center New York New York USAAbstract Objective Compare long‐term voice outcomes in patients treated with FIM or BML for nonparalytic dysphonia. There is controversy whether fat injection medialization (FIM) is a durable alternative to bilateral medialization laryngoplasty (BML) for nonparalytic dysphonia (atrophy, sulcus, scar, paresis). Both interventions yield improved voice quality, yet comparison of patients' long‐term perceptions of their voice after these procedures has not been performed. Methods Retrospective review of patients who underwent FIM or BML for nonparalytic dysphonia was performed from 2008‐2018. Charts were reviewed for demographic information, preoperative diagnosis, intervention, Voice Handicap Index‐10 (VHI‐10), and follow‐up time. Results Forty‐nine patients met our criteria. Fifty procedures were performed (25 FIM, 25 BML). One patient underwent BML with subsequent FIM. There was no significant difference in pre‐treatment or post‐treatment VHI‐10 scores between both groups (Pre‐FIM 21 Post‐FIM 10.28; Pre‐BML 22.48, Post‐BML 10.88). Total median follow‐up time was 11.3 months (FIM 14.8 months, BML 9.5 months). Using VHI‐10 scores recorded at each patient's latest follow‐up visit, both groups demonstrated significant decrease (P < .05) compared to preoperative scores: VHI‐10 decreased by a mean delta of 10.72 in the FIM group and 11.6 in the BML group. There was no significant difference in pre, post and change in VHI between groups. Conclusions In patients with nonparalytic dysphonia, FIM is a durable alternative to BML. Patients treated in both groups gained substantial improvement in vocal function. For both treatment groups, we should anticipate less than complete satisfaction with surgery and revision procedures in a minority of patients. Level of Evidence IV.https://doi.org/10.1002/lio2.573fat injection medializationmedialization laryngoplastynonparalytic dysphoniaVHI‐10
spellingShingle Sarah K. Rapoport
Thomas Murry
Peak Woo
Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
Laryngoscope Investigative Otolaryngology
fat injection medialization
medialization laryngoplasty
nonparalytic dysphonia
VHI‐10
title Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
title_full Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
title_fullStr Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
title_full_unstemmed Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
title_short Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
title_sort voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia
topic fat injection medialization
medialization laryngoplasty
nonparalytic dysphonia
VHI‐10
url https://doi.org/10.1002/lio2.573
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