Medialization Thyroplasty Using Autologous Nasal Septal Cartilage for Treating Unilateral Vocal Fold Paralysis

OBJECTIVES: A persistent insufficiency of glottal closure is mostly a consequence of impaired unilateral vocal fold movement. Functional surgical treatment is required because of the consequential voice, breathing and swallowing impairments. The goal of the study was to determine the functional voice outcomes after medialization thyroplasty with using autologous septal cartilage from the nose. METHODS: External vocal fold medialization using autologous nasal septal cartilage was performed on 15 patients (6 females and 9 males; age range, 30 to 57 years). Detailed functional examinations were performed for all the patients before and after the surgery and this included perceptual voice assessment, laryngostroboscopic examination and acoustic voice analysis. RESULTS: All the patients reported improvement of voice quality post-operatively. Laryngostroboscopy revealed almost complete glottal closure after surgery in the majority of patients. Acoustic and perceptual voice assessment showed significant improvement post-operatively. CONCLUSION: Medialization thyroplasty using an autologous nasal septal cartilage implant offers good tissue tolerability and significant improvement of the subjective and objective functional voice outcomes.

Effect of classic uvulopalatopharyngoplasty and laser-assisted uvulopalatopharyngoplasty on voice acoustics and speech nasalance

Uvulopalatopharyngoplasty [UPPP] is a commonly used surgical technique for oropharyngeal reconstruction in patients with obstructive sleep apnea [OSA]. This procedure can be done either through the classic or the laser-assisted uvulopalatopharyngoplasty [LAUP] technique. The purpose of this study was to evaluate the effect of classic UPPP and LAUP on acoustics of voice and speech nasalance, and to compare the effect of each operation on these two domains. The study included 27 patients with a mean age of 46 years. All patients were diagnosed with OSA based on polysomnographic examination. Patients were divided into two groups according to the type of surgical procedure. Fifteen patients underwent classic UPPP, whereas 12 patients were subjected to LAUP. A full assessment was done for all patients preoperatively and postoperatively, including auditory perceptual assessment [APA] of voice and speech, objective assessment using acoustic voice analysis and nasometry. Auditory perceptual assessment of speech and voice, acoustic analysis of voice and nasometric analysis of speech did not show statistically significant differences between the preoperative and postoperative evaluations in either group [P>.05]. The results of this study demonstrated that in patients with OSA, the surgical technique, whether classic UPPP or LAUP, does not have significant effects on the patients' voice quality or their speech outcomes

Acoustic analysis of normal Saudi adult voices

To determine the acoustic differences between Saudi adult male and female voices, and to compare the acoustic variables of the Multidimensional Voice Program [MDVP] obtained from North American adults to a group of Saudi males and females. A cross-sectional survey of normal adult male and female voices was conducted at King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia between March 2007 and December 2008. Ninety-five Saudi subjects sustained the vowel /a/ 6 times, and the steady state portion of 3 samples was analyzed and compared with the samples of the KayPentax normative voice database. Significant differences were found between Saudi and North American KayPentax database groups. In the male subjects, 15 of 33 MDVP variables, and 10 of 33 variables in the female subjects were found to be significantly different from the KayPentax database. We conclude that the acoustical differences may reflect laryngeal anatomical or tissue differences between the Saudi and the KayPentax database

Accent method of voice therapy for treatment of severe muscle tension dysphonia

Nonorganic dysphonia may present a challenging diagnosis, and management. Here, we present a severe form of nonorganic dysphonia, which we termed as arytenoidal dysphonia. It was a severe form of muscle tension dysphonia, which was described earlier in literature although with different nomenclature. The outcome of the accent method of voice therapy was also presented. We concluded that accent method of voice therapy is proven to be an effective treatment modality of arytenoidal dystonia