A-p positioning of medialization thyroplasty in an excised larynx model

Lukasz Czerwonka, Charles N. Ford, Anthony T. Machi, Glen E. Leverson, Jack J. Jiang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Hypothesis: Posterior positioning of medialization thyroplasty provides the best acoustic and aerodynamic outcomes. Study Design: Ex vivo excised canine larynx. Methods: Unilateral thyroplasty windows were cut in the thyroid cartilages of 10 excised canine larynges. Each larynx was mounted on an artificial lung and the vocal fold opposite the thyroid window was adducted by medializing its arytenoid cartilage. Then, medialization thyroplasty was simulated with a probe placed anterior, central, and posterior in the thyroid window. The glottal area, airway reduction, medialization force, phonation threshold pressure and flow, aerodynamic power, intensity, efficiency, jitter, shimmer, and signal-to-noise ratio (SNR) were measured at each medialization position. Results: Posterior medialization probe placement minimized the glottal area, provided the best voice as determined by perturbation measures and SNR, reduced the work of phonation, and increased efficiency. Anterior and middle probe placement minimized the work of phonation but provided only modest gains in sound quality and decreased sound intensity. Medializing the vocal fold with posterior probe placement required twice as much force as central and anterior probe placement. Conclusions: The results suggest that posterior medialization provides the greatest improvement in acoustic parameters and efficiency in patients who can tolerate the airway reduction. Middle and anterior medialization can decrease work of phonation, but in this experiment objective improvement in sound quality was limited. Subtle changes in displacement shim contour, especially in middle and anterior locations, have a substantial impact on voice outcome, affirming the value of intraoperative voice assessment.

Original languageEnglish (US)
Pages (from-to)591-596
Number of pages6
JournalLaryngoscope
Volume119
Issue number3
DOIs
StatePublished - Mar 1 2009

Fingerprint

Laryngoplasty
Phonation
Larynx
Vocal Cords
Signal-To-Noise Ratio
Acoustics
Canidae
Thyroid Gland
Arytenoid Cartilage
Thyroid Cartilage
Pressure
Lung

Keywords

  • Excised larynx
  • Thyroplasty
  • Voice assessment

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Medicine(all)

Cite this

Czerwonka, L., Ford, C. N., Machi, A. T., Leverson, G. E., & Jiang, J. J. (2009). A-p positioning of medialization thyroplasty in an excised larynx model. Laryngoscope, 119(3), 591-596. https://doi.org/10.1002/lary.20122

A-p positioning of medialization thyroplasty in an excised larynx model. / Czerwonka, Lukasz; Ford, Charles N.; Machi, Anthony T.; Leverson, Glen E.; Jiang, Jack J.

In: Laryngoscope, Vol. 119, No. 3, 01.03.2009, p. 591-596.

Research output: Contribution to journalArticle

Czerwonka, L, Ford, CN, Machi, AT, Leverson, GE & Jiang, JJ 2009, 'A-p positioning of medialization thyroplasty in an excised larynx model', Laryngoscope, vol. 119, no. 3, pp. 591-596. https://doi.org/10.1002/lary.20122
Czerwonka, Lukasz ; Ford, Charles N. ; Machi, Anthony T. ; Leverson, Glen E. ; Jiang, Jack J. / A-p positioning of medialization thyroplasty in an excised larynx model. In: Laryngoscope. 2009 ; Vol. 119, No. 3. pp. 591-596.
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