Long-term outcomes of bilateral medialisation thyroplasty in patients with vocal fold atrophy with or without sulcus

J Laryngol Otol. 2024 May;138(5):570-575. doi: 10.1017/S0022215123001640. Epub 2023 Oct 2.

Abstract

Objective: Evaluate long-term voice outcome after bilateral medialisation thyroplasty in glottic insufficiency due to vocal fold atrophy with or without sulcus.

Methods: Patients after medialisation thyroplasty for vocal fold atrophy with or without sulcus were identified. Long-term post-operative subjective voice outcomes (> 1 year) using Voice Handicap Index-30, subjective ratings on voice aspects and study-specific questionnaire were compared to pre-operative and shorter-term (1 year) values.

Results: Thirty-six patients were identified, of which 26 were included (16 atrophy, 10 sulcus) with median follow up of 6.7 years. Mean Voice Handicap Index score at > 1 year (40.0) showed clinically relevant (≥ 15 for groups) and statistically significant improvement compared to pre-operative score (58.1) and remained stable compared to post-operative score (35.7) at one year. Ten patients (56 per cent) reported clinically relevant improvement (≥ 10) after more than five years.

Conclusion: Long-term improvement in subjective voice outcomes is attainable in a significant proportion of patients undergoing bilateral medialisation thyroplasty for atrophy with or without sulcus.

Keywords: Glottic insufficiency; bilateral medialization thyroplasty; laryngoplasty; sulcus; type 1 thyroplasty; vocal fold atrophy.

MeSH terms

  • Adult
  • Aged
  • Atrophy* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngoplasty* / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vocal Cord Paralysis / surgery
  • Vocal Cords* / pathology
  • Vocal Cords* / surgery
  • Voice Quality*