Isolated Recovery of Adductor Muscle Function Following Bilateral Recurrent Laryngeal Nerve Injuries
Objectives/Hypothesis The aim of this study was to analyze the phoniatric and respiratory outcomes of a subset of bilateral vocal cord paralysis (BVCP) patients who were all treated with unilateral endoscopic arytenoid abduction lateropexy (EAAL). EAAL is a nondestructive, minimally invasive glottis...
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| Veröffentlicht in: | The Laryngoscope 2019-10, Vol.129 (10), p.2334-2340 |
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| container_title | The Laryngoscope |
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| creator | Bach, Ádám Sztanó, Balázs Matievics, Vera Bere, Zsófia Volk, Fabian Müller, Andreas Förster, Gerhard Castellanos, Paul F. Rovó, László |
| description | Objectives/Hypothesis
The aim of this study was to analyze the phoniatric and respiratory outcomes of a subset of bilateral vocal cord paralysis (BVCP) patients who were all treated with unilateral endoscopic arytenoid abduction lateropexy (EAAL). EAAL is a nondestructive, minimally invasive glottis widening operation, which does not damage either the surgically treated or the contralateral vocal cord. Therefore, it does not impair the regeneration potential of the recurrent laryngeal nerve.
Study Design
Case series.
Methods
Ten out of 21 BVCP patients who were treated with EAAL showed signs of isolated adduction recovery at 1 year and were chosen for this study. Functional results (objective and subjective voice analysis, spirometric measurement) and vocal cord movements were assessed preoperatively, 1 week and 1 year after EAAL. Laryngeal electromyography was performed on the 12th postoperative month.
Results
The volitional adductor movement seen on laryngoscopy was corroborated by laryngeal electromyography evaluation. Peak inspiratory flow increased significantly after EAAL. Quality‐of‐life scores also showed high patient satisfaction. Shimmer showed consistent improvement along with harmonic‐to‐noise ratio and average maximal phonation time in parallel with the improving vocal cord movement. Complex voice analysis and subjective self‐evaluation tests also demonstrated significant improvement.
Conclusions
EAAL, as a minimally invasive, nondestructive airway widening technique, does not interfere with the potential regeneration process that can still occur after BVCP, allowing for laryngeal functional recovery. It is a safe and effective treatment for BVCP that allows a simple solution with good phonatory, swallowing, and respiratory benefits by unilateral passive and reversible vocal cord lateralization.
Level of Evidence
4
Laryngoscope, 129:2334–2340, 2019 |
| doi_str_mv | 10.1002/lary.27718 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2157650640</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2299151310</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3578-451f0beff426b3e36c6239b4b186b9b1e18acfe84df403b558361d6d2e02b1a33</originalsourceid><addsrcrecordid>eNp9kEFr3DAQhUVoSDbbXPIDgqCXUnCikSxbPm5CN13YJBBaaE7CksfBi9ZKJSth_33tbtpDDj0NzHzv8eYRcgbsAhjjl64OuwtelqAOyAykgCyvKvmBzMajyJTkP4_JSYwbxqAUkh2RY8FkrpTiM9Ksonf1gA19QOtfMOyob-miaZIdfKC3KVqHdJl6O3S-p0vvnH_t-id61U2yULtJmELAfqDrMUj_hOPuDsML0lW_SaHD-JEctrWLePo25-TH8uv362_Z-v5mdb1YZ1bIUmW5hJYZbNucF0agKGzBRWVyA6owlQEEVdsWVd60ORNGSiUKaIqGI-MGaiHm5PPe9zn4XwnjoLddtOhc3aNPUXOQZSFZMarn5NM7dONT6Md0mvOqAgkCJurLnrLBxxiw1c-h245famB66l5P3es_3Y_w-ZtlMlts_qF_yx4B2AOvncPdf6z0evHwuDf9DXC8j0U</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2299151310</pqid></control><display><type>article</type><title>Isolated Recovery of Adductor Muscle Function Following Bilateral Recurrent Laryngeal Nerve Injuries</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Bach, Ádám ; Sztanó, Balázs ; Matievics, Vera ; Bere, Zsófia ; Volk, Fabian ; Müller, Andreas ; Förster, Gerhard ; Castellanos, Paul F. ; Rovó, László</creator><creatorcontrib>Bach, Ádám ; Sztanó, Balázs ; Matievics, Vera ; Bere, Zsófia ; Volk, Fabian ; Müller, Andreas ; Förster, Gerhard ; Castellanos, Paul F. ; Rovó, László</creatorcontrib><description>Objectives/Hypothesis
The aim of this study was to analyze the phoniatric and respiratory outcomes of a subset of bilateral vocal cord paralysis (BVCP) patients who were all treated with unilateral endoscopic arytenoid abduction lateropexy (EAAL). EAAL is a nondestructive, minimally invasive glottis widening operation, which does not damage either the surgically treated or the contralateral vocal cord. Therefore, it does not impair the regeneration potential of the recurrent laryngeal nerve.
Study Design
Case series.
Methods
Ten out of 21 BVCP patients who were treated with EAAL showed signs of isolated adduction recovery at 1 year and were chosen for this study. Functional results (objective and subjective voice analysis, spirometric measurement) and vocal cord movements were assessed preoperatively, 1 week and 1 year after EAAL. Laryngeal electromyography was performed on the 12th postoperative month.
Results
The volitional adductor movement seen on laryngoscopy was corroborated by laryngeal electromyography evaluation. Peak inspiratory flow increased significantly after EAAL. Quality‐of‐life scores also showed high patient satisfaction. Shimmer showed consistent improvement along with harmonic‐to‐noise ratio and average maximal phonation time in parallel with the improving vocal cord movement. Complex voice analysis and subjective self‐evaluation tests also demonstrated significant improvement.
Conclusions
EAAL, as a minimally invasive, nondestructive airway widening technique, does not interfere with the potential regeneration process that can still occur after BVCP, allowing for laryngeal functional recovery. It is a safe and effective treatment for BVCP that allows a simple solution with good phonatory, swallowing, and respiratory benefits by unilateral passive and reversible vocal cord lateralization.
Level of Evidence
4
Laryngoscope, 129:2334–2340, 2019</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.27718</identifier><identifier>PMID: 30548882</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Adult ; Aged ; airway stenosis ; dysphonia ; Electromyography ; Female ; Glottis - surgery ; Humans ; laryngeal electromyography ; Laryngeal Muscles - physiopathology ; Laryngeal Muscles - surgery ; Laryngoscopy - methods ; Male ; Middle Aged ; Patient satisfaction ; Phonation ; Postoperative Period ; Quality of life ; Recovery of Function ; Recurrent Laryngeal Nerve Injuries - complications ; Recurrent Laryngeal Nerve Injuries - physiopathology ; Recurrent Laryngeal Nerve Injuries - surgery ; Spirometry ; Throat surgery ; Treatment Outcome ; vocal cord paralysis ; Vocal Cord Paralysis - etiology ; Vocal Cord Paralysis - physiopathology ; Vocal Cord Paralysis - surgery ; Vocal Cords - physiopathology ; Vocal Cords - surgery ; Voice - physiology</subject><ispartof>The Laryngoscope, 2019-10, Vol.129 (10), p.2334-2340</ispartof><rights>2018 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2019 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3578-451f0beff426b3e36c6239b4b186b9b1e18acfe84df403b558361d6d2e02b1a33</citedby><cites>FETCH-LOGICAL-c3578-451f0beff426b3e36c6239b4b186b9b1e18acfe84df403b558361d6d2e02b1a33</cites><orcidid>0000-0001-9265-1043 ; 0000-0002-9925-4849 ; 0000-0002-9820-5527</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.27718$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.27718$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30548882$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bach, Ádám</creatorcontrib><creatorcontrib>Sztanó, Balázs</creatorcontrib><creatorcontrib>Matievics, Vera</creatorcontrib><creatorcontrib>Bere, Zsófia</creatorcontrib><creatorcontrib>Volk, Fabian</creatorcontrib><creatorcontrib>Müller, Andreas</creatorcontrib><creatorcontrib>Förster, Gerhard</creatorcontrib><creatorcontrib>Castellanos, Paul F.</creatorcontrib><creatorcontrib>Rovó, László</creatorcontrib><title>Isolated Recovery of Adductor Muscle Function Following Bilateral Recurrent Laryngeal Nerve Injuries</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
The aim of this study was to analyze the phoniatric and respiratory outcomes of a subset of bilateral vocal cord paralysis (BVCP) patients who were all treated with unilateral endoscopic arytenoid abduction lateropexy (EAAL). EAAL is a nondestructive, minimally invasive glottis widening operation, which does not damage either the surgically treated or the contralateral vocal cord. Therefore, it does not impair the regeneration potential of the recurrent laryngeal nerve.
Study Design
Case series.
Methods
Ten out of 21 BVCP patients who were treated with EAAL showed signs of isolated adduction recovery at 1 year and were chosen for this study. Functional results (objective and subjective voice analysis, spirometric measurement) and vocal cord movements were assessed preoperatively, 1 week and 1 year after EAAL. Laryngeal electromyography was performed on the 12th postoperative month.
Results
The volitional adductor movement seen on laryngoscopy was corroborated by laryngeal electromyography evaluation. Peak inspiratory flow increased significantly after EAAL. Quality‐of‐life scores also showed high patient satisfaction. Shimmer showed consistent improvement along with harmonic‐to‐noise ratio and average maximal phonation time in parallel with the improving vocal cord movement. Complex voice analysis and subjective self‐evaluation tests also demonstrated significant improvement.
Conclusions
EAAL, as a minimally invasive, nondestructive airway widening technique, does not interfere with the potential regeneration process that can still occur after BVCP, allowing for laryngeal functional recovery. It is a safe and effective treatment for BVCP that allows a simple solution with good phonatory, swallowing, and respiratory benefits by unilateral passive and reversible vocal cord lateralization.
Level of Evidence
4
Laryngoscope, 129:2334–2340, 2019</description><subject>Adult</subject><subject>Aged</subject><subject>airway stenosis</subject><subject>dysphonia</subject><subject>Electromyography</subject><subject>Female</subject><subject>Glottis - surgery</subject><subject>Humans</subject><subject>laryngeal electromyography</subject><subject>Laryngeal Muscles - physiopathology</subject><subject>Laryngeal Muscles - surgery</subject><subject>Laryngoscopy - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient satisfaction</subject><subject>Phonation</subject><subject>Postoperative Period</subject><subject>Quality of life</subject><subject>Recovery of Function</subject><subject>Recurrent Laryngeal Nerve Injuries - complications</subject><subject>Recurrent Laryngeal Nerve Injuries - physiopathology</subject><subject>Recurrent Laryngeal Nerve Injuries - surgery</subject><subject>Spirometry</subject><subject>Throat surgery</subject><subject>Treatment Outcome</subject><subject>vocal cord paralysis</subject><subject>Vocal Cord Paralysis - etiology</subject><subject>Vocal Cord Paralysis - physiopathology</subject><subject>Vocal Cord Paralysis - surgery</subject><subject>Vocal Cords - physiopathology</subject><subject>Vocal Cords - surgery</subject><subject>Voice - physiology</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEFr3DAQhUVoSDbbXPIDgqCXUnCikSxbPm5CN13YJBBaaE7CksfBi9ZKJSth_33tbtpDDj0NzHzv8eYRcgbsAhjjl64OuwtelqAOyAykgCyvKvmBzMajyJTkP4_JSYwbxqAUkh2RY8FkrpTiM9Ksonf1gA19QOtfMOyob-miaZIdfKC3KVqHdJl6O3S-p0vvnH_t-id61U2yULtJmELAfqDrMUj_hOPuDsML0lW_SaHD-JEctrWLePo25-TH8uv362_Z-v5mdb1YZ1bIUmW5hJYZbNucF0agKGzBRWVyA6owlQEEVdsWVd60ORNGSiUKaIqGI-MGaiHm5PPe9zn4XwnjoLddtOhc3aNPUXOQZSFZMarn5NM7dONT6Md0mvOqAgkCJurLnrLBxxiw1c-h245famB66l5P3es_3Y_w-ZtlMlts_qF_yx4B2AOvncPdf6z0evHwuDf9DXC8j0U</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Bach, Ádám</creator><creator>Sztanó, Balázs</creator><creator>Matievics, Vera</creator><creator>Bere, Zsófia</creator><creator>Volk, Fabian</creator><creator>Müller, Andreas</creator><creator>Förster, Gerhard</creator><creator>Castellanos, Paul F.</creator><creator>Rovó, László</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9265-1043</orcidid><orcidid>https://orcid.org/0000-0002-9925-4849</orcidid><orcidid>https://orcid.org/0000-0002-9820-5527</orcidid></search><sort><creationdate>201910</creationdate><title>Isolated Recovery of Adductor Muscle Function Following Bilateral Recurrent Laryngeal Nerve Injuries</title><author>Bach, Ádám ; Sztanó, Balázs ; Matievics, Vera ; Bere, Zsófia ; Volk, Fabian ; Müller, Andreas ; Förster, Gerhard ; Castellanos, Paul F. ; Rovó, László</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3578-451f0beff426b3e36c6239b4b186b9b1e18acfe84df403b558361d6d2e02b1a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>airway stenosis</topic><topic>dysphonia</topic><topic>Electromyography</topic><topic>Female</topic><topic>Glottis - surgery</topic><topic>Humans</topic><topic>laryngeal electromyography</topic><topic>Laryngeal Muscles - physiopathology</topic><topic>Laryngeal Muscles - surgery</topic><topic>Laryngoscopy - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient satisfaction</topic><topic>Phonation</topic><topic>Postoperative Period</topic><topic>Quality of life</topic><topic>Recovery of Function</topic><topic>Recurrent Laryngeal Nerve Injuries - complications</topic><topic>Recurrent Laryngeal Nerve Injuries - physiopathology</topic><topic>Recurrent Laryngeal Nerve Injuries - surgery</topic><topic>Spirometry</topic><topic>Throat surgery</topic><topic>Treatment Outcome</topic><topic>vocal cord paralysis</topic><topic>Vocal Cord Paralysis - etiology</topic><topic>Vocal Cord Paralysis - physiopathology</topic><topic>Vocal Cord Paralysis - surgery</topic><topic>Vocal Cords - physiopathology</topic><topic>Vocal Cords - surgery</topic><topic>Voice - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bach, Ádám</creatorcontrib><creatorcontrib>Sztanó, Balázs</creatorcontrib><creatorcontrib>Matievics, Vera</creatorcontrib><creatorcontrib>Bere, Zsófia</creatorcontrib><creatorcontrib>Volk, Fabian</creatorcontrib><creatorcontrib>Müller, Andreas</creatorcontrib><creatorcontrib>Förster, Gerhard</creatorcontrib><creatorcontrib>Castellanos, Paul F.</creatorcontrib><creatorcontrib>Rovó, László</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bach, Ádám</au><au>Sztanó, Balázs</au><au>Matievics, Vera</au><au>Bere, Zsófia</au><au>Volk, Fabian</au><au>Müller, Andreas</au><au>Förster, Gerhard</au><au>Castellanos, Paul F.</au><au>Rovó, László</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Isolated Recovery of Adductor Muscle Function Following Bilateral Recurrent Laryngeal Nerve Injuries</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2019-10</date><risdate>2019</risdate><volume>129</volume><issue>10</issue><spage>2334</spage><epage>2340</epage><pages>2334-2340</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
The aim of this study was to analyze the phoniatric and respiratory outcomes of a subset of bilateral vocal cord paralysis (BVCP) patients who were all treated with unilateral endoscopic arytenoid abduction lateropexy (EAAL). EAAL is a nondestructive, minimally invasive glottis widening operation, which does not damage either the surgically treated or the contralateral vocal cord. Therefore, it does not impair the regeneration potential of the recurrent laryngeal nerve.
Study Design
Case series.
Methods
Ten out of 21 BVCP patients who were treated with EAAL showed signs of isolated adduction recovery at 1 year and were chosen for this study. Functional results (objective and subjective voice analysis, spirometric measurement) and vocal cord movements were assessed preoperatively, 1 week and 1 year after EAAL. Laryngeal electromyography was performed on the 12th postoperative month.
Results
The volitional adductor movement seen on laryngoscopy was corroborated by laryngeal electromyography evaluation. Peak inspiratory flow increased significantly after EAAL. Quality‐of‐life scores also showed high patient satisfaction. Shimmer showed consistent improvement along with harmonic‐to‐noise ratio and average maximal phonation time in parallel with the improving vocal cord movement. Complex voice analysis and subjective self‐evaluation tests also demonstrated significant improvement.
Conclusions
EAAL, as a minimally invasive, nondestructive airway widening technique, does not interfere with the potential regeneration process that can still occur after BVCP, allowing for laryngeal functional recovery. It is a safe and effective treatment for BVCP that allows a simple solution with good phonatory, swallowing, and respiratory benefits by unilateral passive and reversible vocal cord lateralization.
Level of Evidence
4
Laryngoscope, 129:2334–2340, 2019</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>30548882</pmid><doi>10.1002/lary.27718</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-9265-1043</orcidid><orcidid>https://orcid.org/0000-0002-9925-4849</orcidid><orcidid>https://orcid.org/0000-0002-9820-5527</orcidid></addata></record> |
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| source | MEDLINE; Wiley Journals |
| subjects | Adult Aged airway stenosis dysphonia Electromyography Female Glottis - surgery Humans laryngeal electromyography Laryngeal Muscles - physiopathology Laryngeal Muscles - surgery Laryngoscopy - methods Male Middle Aged Patient satisfaction Phonation Postoperative Period Quality of life Recovery of Function Recurrent Laryngeal Nerve Injuries - complications Recurrent Laryngeal Nerve Injuries - physiopathology Recurrent Laryngeal Nerve Injuries - surgery Spirometry Throat surgery Treatment Outcome vocal cord paralysis Vocal Cord Paralysis - etiology Vocal Cord Paralysis - physiopathology Vocal Cord Paralysis - surgery Vocal Cords - physiopathology Vocal Cords - surgery Voice - physiology |
| title | Isolated Recovery of Adductor Muscle Function Following Bilateral Recurrent Laryngeal Nerve Injuries |
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