Medialization thyroplasty versus injection laryngoplasty for unilateral vocal fold paralysis: A comparative analysis of functional outcomes

The primary objective of this investigation was to determine whether medialization thyroplasty (MT) or injection laryngoplasty (IL) offered significant short- and long-term functional improvements in vocal function in patients with unilateral vocal fold paralysis (UVFP). Prospective analyses of 10 patients who received MT were compared to similar data obtained from a companion subgroup of 10 patients who underwent IL. Specifically, videostoboscopic data, audio recordings, maximum phonation time (MPT), and dysphagia questionnaires were obtained pre- and postoperatively at various intervals. These examinations were conducted in a university-based, speech, voice, and swallowing physiology clinic and laboratory. Results revealed that both MT and IL promoted significant improvements in MPT. For the IL subjects, these gains lasted less than 6 months. For the MT subjects, the gains were sustained over a much longer period. Only the MT subjects demonstrated significant and long-term improvements in perceptual voice ratings postoperatively. Improvements in swallowing proficiency were noted in both the MT and IL subgroups, but the gains were not significant. A useful algorithm is provided for behavioral and surgical management of UVFP patients.