Prospective Multi-arm Evaluation of Surgical Treatments for Vocal Fold Scar and Pathologic Sulcus Vocalis

Overview

Journal Laryngoscope

Specialty Otorhinolaryngology

Date 2011 May 11

PMID 21557241

Citations 33

Authors

Nathan V Welham

Seong Hee Choi

Seth H Dailey

Charles N Ford

Jack J Jiang

Diane M Bless

Affiliations

Soon will be listed here.

Abstract

Objectives/hypothesis: The purpose of this study was to compare the clinical effectiveness of type I thyroplasty, injection laryngoplasty, and graft implantation for the treatment of vocal fold scar and pathologic sulcus vocalis.

Study Design: Prospective, multi-arm, quasi-experimental research design.

Methods: Twenty-eight patients with newly diagnosed vocal fold scar and/or pathologic sulcus vocalis were assigned to one of three treatment modalities: type I thyroplasty (n = 9), injection laryngoplasty (n = 9), and graft implantation (n = 10). Psychosocial, auditory-perceptual, acoustic, aerodynamic, and videostroboscopic data were collected pretreatment and at 1, 6, 12, and 18 months posttreatment.

Results: Type I thyroplasty and graft implantation both resulted in reduced voice handicap with no concomitant improvement in auditory-perceptual, acoustic, aerodynamic, or vocal fold physiologic performance. Injection laryngoplasty resulted in no improvement on any vocal function index. Patients who underwent graft implantation exhibited the slowest improvement trajectory across the 18-month follow-up period.

Conclusions: A persistent challenge in this area is that no single treatment modality is successful for the majority of patients, and there is no evidence-based decision algorithm for matching a given treatment to a given patient. Progress therefore requires the identification and categorization of predictive clinical features that can drive evidence-based treatment assignment.

Citing Articles

Prospective Outcomes After Serial Platelet-Rich Plasma (PRP) Injection in Vocal Fold Scar and Sulcus.

Maria C, Shuman E, van der Woerd B, Moffatt C, Castellanos C, Gao W Laryngoscope. 2024; 134(12):5021-5027.

PMID: 39115162 PMC: 11563877. DOI: 10.1002/lary.31683.

The Utility of Stroboscopy in Evaluating Patients with Benign Vocal Fold Lesions.

Zarachi A, Tafiadis D, Exarchakos G, Lianou A, Liontos A, Psychogios G Maedica (Bucur). 2023; 18(3):504-509.

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Treatment efficacy of 532-nm diode laser glottoplasty in patients with sulcus vocalis: a prospective study.

Lee J, Kang H, Park K, Lee S Eur Arch Otorhinolaryngol. 2023; 281(1):295-299.

PMID: 37938373 DOI: 10.1007/s00405-023-08277-2.

Platelet-rich plasma in treatment of scar, atrophy, and sulcus: Short- and long-term results.

Woo P Laryngoscope Investig Otolaryngol. 2023; 8(5):1304-1311.

PMID: 37899871 PMC: 10601577. DOI: 10.1002/lio2.1143.

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

van den Broek E, Heijnen B, van der Valk J, Hendriksma M, Langeveld A, van Benthem P J Laryngol Otol. 2023; 138(5):570-575.

PMID: 37781766 PMC: 11063655. DOI: 10.1017/S0022215123001640.

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