ABSTRACT
INTRODUCTION AND OBJECTIVE: The purposes of this study are to demonstrate the use of the mobile voice lab in type I thyroplasty with Gore-Tex(®) using analysis of spectrogram and fundamental frequency in the operating room, and also to show how to do this procedure. METHODS: Voice samples were recorded in the operating room immediately before and during type I thyroplasty. Six-week postoperative samples were also taken in the voice laboratory. Fundamental frequency and spectral analysis were analyzed. Spectrograms were evaluated by blind panel of 4 judges on a 100mm visual analogue scale. All three time points were compared and statistical analysis performed. Pre and postoperative V-RQOL scores were also compared. RESULTS: Significant improvement in spectrogram ratings were seen between before and during (P<.001), and before and after voice samples (P<.017). There was no significant difference between during and after scores, suggesting the persistence of the intraoperative improvement in this measure. Changes in fundamental frequency were not statistically significant, although fundamental frequency tended to increase in women and decrease in men after type I thyroplasty. Mean V-RQOL scores improved from 48.08 a 85.08 (P<.001). CONCLUSIONS: The mobile voice laboratory may be useful during type I thyroplasty with Gore-Tex(®). It offers an opportunity for the surgeon and voice pathologist to continue to collaborate in the treatment of patients with unilateral vocal fold paralysis.
Subject(s)
Diagnosis, Computer-Assisted/methods , Dysphonia/prevention & control , Intraoperative Care/methods , Laryngoplasty/methods , Polytetrafluoroethylene , Sound Spectrography , Surgical Mesh , Vocal Cord Paralysis/surgery , Voice Quality , Anesthesia, Local , Deglutition Disorders/diagnosis , Deglutition Disorders/surgery , Diagnosis, Computer-Assisted/instrumentation , Dysphonia/etiology , Female , Glottis/physiopathology , Humans , Intraoperative Care/instrumentation , Intraoperative Complications/etiology , Intraoperative Complications/physiopathology , Laryngeal Edema/etiology , Laryngeal Edema/physiopathology , Laryngoplasty/adverse effects , Male , Microcomputers , Observer Variation , Quality of Life , Single-Blind Method , Software , Sound Spectrography/instrumentation , Sound Spectrography/methods , Surveys and Questionnaires , Vocal Cord Paralysis/complications , Vocal Cord Paralysis/diagnosisABSTRACT
Diagnosis and treatment of the immobile or hypomobile vocal fold are challenging for the otolaryngologist. True paralysis and paresis result from vocal fold denervation secondary to injury to the laryngeal or vagus nerve. Vocal fold paresis or paralysis may be unilateral or bilateral, central or peripheral, and it may involve the recurrent laryngeal nerve, superior laryngeal nerve, or both. The physician's first responsibility in any case of vocal fold paresis or paralysis is to confirm the diagnosis and be certain that the laryngeal motion impairment is not caused by arytenoid cartilage dislocation or subluxation, cricoarytenoid arthritis or ankylosis, neoplasm, or other mechanical causes. Strobovideolaryngoscopy, endoscopy, radiologic and laboratory studies, and electromyography are all useful diagnostic tools.