Medialization laryngoplasty for odynophonia

JAMA Otolaryngol Head Neck Surg. 2015 Jun;141(6):556-61. doi: 10.1001/jamaoto.2015.0333.

Abstract

Importance: Medialization laryngoplasty (ML) remains the gold standard for the long-term treatment of hoarseness related to glottal insufficiency. Odynophonia is a less common manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI), and ML is hypothesized to relieve pain associated with this condition.

Objective: To evaluate whether patients with VFMI and a chief complaint of odynophonia may achieve pain relief with ML, regardless of the degree of vocal impairment.

Design, setting, and participants: We conducted a retrospective review of medical records for 8 patients with VFMI and a chief complaint of odynophonia who were treated at 2 tertiary care laryngology centers over a 2-year period.

Interventions: All patients underwent ML.

Main outcomes and measures: Patient-reported relief of pain, preoperative and postoperative Voice Handicap Index 10 (VHI-10) scores, and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores were obtained.

Results: All eight patients (5 women and 3 men; mean age, 42 years) had durable relief of their discomfort postoperatively (average follow-up, 14 months). Mean VHI-10 scores improved significantly from 17.9 preoperatively to 6.3 postoperatively (P = .001), while perceptual voice parameters as measured by CAPE-V were unchanged. There were no complications.

Conclusions and relevance: In select cases of VFMI, ML can relieve pain related to voice use, even in the absence of significant hoarseness.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cicatrix / diagnosis
  • Cicatrix / etiology
  • Dysphonia / complications
  • Dysphonia / surgery*
  • Female
  • Follow-Up Studies
  • Granuloma / diagnosis
  • Granuloma / etiology
  • Humans
  • Laryngeal Diseases / diagnosis
  • Laryngeal Diseases / etiology
  • Laryngoplasty / adverse effects
  • Laryngoplasty / methods*
  • Male
  • Middle Aged
  • Pain Measurement
  • Retrospective Studies
  • Stroboscopy
  • Treatment Outcome
  • Vocal Cord Paralysis / diagnosis
  • Vocal Cord Paralysis / etiology
  • Vocal Cords / surgery*
  • Voice Quality