Validation of the 10-Item Unilateral Vocal Fold Paralysis-Handicap Index quality of life questionnaire.

OBJECTIVES: To validate and test the reliability of the 10-Item Unilateral Vocal Fold Paralysis-Voice Handicap Index (UVFP-HI-10) quality of life (QoL) questionnaire for patients with UVFP. DESIGN: Prospective describe study based on perceptive surveys. PARTICIPANTS: We recruited 61 patients with UVFP and 53 healthy individuals comprised the control group. MAIN OUTCOME MEASURES: Both the patients and controls completed the UVFP-HI-10 questionnaire. A statistical analysis was performed to assess the internal consistency and validity of the survey. In addition, maximum phonation time (MPT) was used to objectively measure patient QoL. RESULTS: Internal consistency was high (α = .914) and the correlation with MPT was significant (rs = -0.722). The estimated marginal mean in the discriminant validity study was around seven times higher in the UVFP group compared to the controls. The UVFP-HI-10 cut-off value was more than 0.9 and the sensitivity and specificity were more than 0.8. CONCLUSIONS: The UVFP-HI-10 is a self-administered patient-reported outcome questionnaire with a high reliability and excellent criterion-based validity. This questionnaire can be used to evaluate specific clinical complaints (e.g., vocalisation, swallowing, and breathing) in terms of their impact on QoL in patients with UVFP. Thus, its use is appropriate as a basic assessment tool as part of a specific UVFP treatment protocol.

Modified Montgomery thyroplasty: Customisation of the cartilage window according to laryngeal anatomy.

We described a Montgomery's thyroplasty using a set of measurement devices designed to achieve accurate individualised prosthesis placement. The objective of the present study was to describe the surgical techniques employed via a step-by-step video and show our results. In total, 42 modified thyroplasties were performed during the 10-year study period. The verification of both points: adequate location and size of the prosthesis are the keys to the success of this intervention. The individualisation of the cartilage window location produces optimal functional results in patients post-intervention in terms of the MPT, GRB score, and VHI-30.

Laryngotracheal Complications after Intubation for COVID-19: A Multicenter Study.

Many of the patients with COVID-19 have suffered respiratory distress requiring prolonged endotracheal intubation (ETI) resulting in laryngotracheal complication with an impact on breathing, phonation, and swallowing. Our aim is to describe laryngeal injuries diagnosed after ETI in patients with COVID-19 in a multicentre study. METHODS: A prospective descriptive observational study was conducted from January 2021 to December 2021, including COVID-19 patients with laryngeal complications due to ETI diagnosed in several Spanish hospitals. We analyzed the epidemiological data, previous comorbidities, mean time to ICU admission and ETI, need for tracheostomy, mean time on invasive mechanical ventilation until tracheostomy or weaning, mean time in ICU, type of residual lesions, and their treatment. RESULTS: We obtained the collaboration of nine hospitals during the months of January 2021 to December 2021. A total of 49 patients were referred. Tracheostomy was performed in 44.9%, being late in most cases (more than 7-10 days). The mean number of days of ETI until extubation was 17.63 days, and the main post-intubation symptoms were dysphonia, dyspnea, and dysphagia, in 87.8%, 34.7%, and 42.9%, respectively. The most frequent injury was altered laryngeal mobility, present in 79.6%. Statistically, there is a greater amount of stenosis after late ETI and after delayed tracheostomy, not observing the data with the immobility alterations. CONCLUSION: The mean number of days of ETI was long, according to the latest guidelines, with the need for several cycles of pronation. This long ETI may have had an impact on the increase of subsequent laryngeal sequelae, such as altered laryngeal mobility or stenosis.

¿Qué nos aporta la estroboscopia en el diagnóstico de los trastornos de la voz? / What is the contribution of stroboscopy in the diagnosis of voice disorders?

En el tratamiento de los trastornos persistentes de la voz es aconsejable la actuación conjunta del otorrinolaringólogo/fonocirujano, foniatra y logopeda. El diagnóstico de las lesiones vocales es esencial para un enfoque terapéutico adecuado. La estroboscopia aporta datos funcionales útiles para decidir un tratamiento quirúrgico, logopédico o combinado. Hemos revisado nuestros casos intervenidos de fonocirugía de los últimos 5 años y analizado la correlación que existe entre el diagnóstico preoperatorio con estroboscopia y los hallazgos intraoperatorios. En el 90% de los casos, existe una concordancia entre ambos diagnósticos. Consideramos que la estroboscopia es un medio de exploración imprescindible para establecer la indicación terapéutica adecuada y orientar al cirujano para el tratamiento quirúrgico (AU)

The management of voice disorders requires a close collaboration between the throat surgeon and the speech therapy team. The diagnosis of cordal lesions is essential to an accurate therapy. Stroboscopy contributes functional information which is useful to decide between microsurgery, vocal reeducation or a combined treatment. We have reviewed our phonomicrosurgery cases for the past five years and analyzed the correlation between preoperative diagnosis obtained by stroboscopy and intraoperative findings. In 90% of cases there exists a relation between both diagnoses. We consider stroboscopy as an essential means of evaluation to establish an adequate management and guidance for surgical treatment (AU)

[What is the contribution of stroboscopy in the diagnosis of voice disorders?]. / Qué nos aporta la estroboscopia en el diagnóstico de los trastornos de la voz?

The management of voice disorders requires a close collaboration between the throat surgeon and the speech therapy team. The diagnosis of cordal lesions is essential to an accurate therapy. Stroboscopy contributes functional information which is useful to decide between microsurgery, vocal reeducation or a combined treatment. We have reviewed our phonomicrosurgery cases for the past five years and analyzed the correlation between preoperative diagnosis obtained by stroboscopy and intraoperative findings. In 90% of cases there exists a relation between both diagnoses. We consider stroboscopy as an essential means of evaluation to establish an adequate management and guidance for surgical treatment.