Airway flow dynamics and voice acoustics after autologous fascia augmentation of paralyzed vocal fold.

The aim of this study was to assess the effect of vocal fold medialization, accomplished by injection of autologous fascia, on airflow dynamics and voice acoustics. Ten patients with unilateral vocal fold paralysis were included. Flow-volume spirometry, body plethysmography, and acoustic analysis of voice were performed within 1 week before injection of autologous fascia and 4 to 14 months after operation. Medialization of the paralyzed vocal fold decreased the mean peak inspiratory flow (PIF) from 4.63 L to 4.10 L (p = .012). The acoustic characteristics of the voice improved: the values of jitter, shimmer, and mean noise-to-harmonics ratio decreased significantly (p = .006, p = .017, and p = .047, respectively), and the mean maximal phonation time almost doubled (p = .002). Changes in PIF and shimmer showed a negative correlation (r = -.857, p = .007). In conclusion, injection of autologous fascia improves voice acoustics, but induces a slight abnormal limitation on PIF. The results also suggest that improvement in voice acoustics is most prominent in subjects with the least deterioration in inspiratory airflow.

Voice acoustics after autologous fascia injection for vocal fold paralysis.

OBJECTIVES: The present study was carried out to assess the impact of fascial injection on voice acoustics Preliminary results had suggested that voice, as rated by a panel of listeners, was significantly improved after autologous fascia augmentation of a paralyzed vocal fold. STUDY DESIGN: A prospective study among patients with unilateral vocal fold paralysis was carried out. Eighteen subjects were analyzed 9 months (mean) after the procedure. METHODS: The preoperative and postoperative samples of vowel /a/ were analyzed by Key Elemetrics (Lincoln Park, NJ). Computerized Speech Lab. RESULTS: There was a significant improvement (P<.05) in all parameters measured, including jitter, shimmer, noise-to-harmonic ratio, and maximum phonation time. No laryngeal complications were seen. CONCLUSIONS: According to these preliminary results, vocal fold augmentation by an injection of autologous fascia seems a simple, inexpensive, reliable and safe method to restore voice quality after unilateral vocal fold paralysis.