Multi-institutional Evaluation of Medialization Laryngoplasty in the Elderly

Ramez Philips, Kevin Chorath, Brad DeSilva, L. Arick Forrest, C. Blake Simpson, Laura Matrka

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To evaluate voice outcomes of medialization laryngoplasty in the elderly population (65 years and older) and to identify swallow outcomes, complication rates, and predictors of voice outcomes. Study Design: Case series with chart review. Setting: Two tertiary academic medical centers. Subjects and Methods: We retrospectively reviewed charts of 136 patients age 65 years and older undergoing medialization laryngoplasty between January 2008 and May 2016 at 2 tertiary academic institutions. Primary outcome was assessed using Voice Handicap Index 10 (VHI-10) score and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) score. Secondary outcomes were assessed using the Eating Assessment Tool 10 (EAT-10) when dysphagia was present, stroboscopic analysis of glottic closure, and complication rates. A logistic regression analysis assessed predictors of voice improvement after medialization laryngoplasty. Results: Total GRBAS and VHI-10 scores showed a significant improvement postoperatively (P <.05). A ≥20% improvement was seen in 81.6% of patients, and a ≥50% improvement was seen in 53.7%. No patient had major complications. Minor complications occurred in 5.9% of patients. Multivariable logistic regression identified preoperative injection augmentation as an independent predictor of less improvement in VHI-10 score (P =.015). Voice therapy prior to medialization did not affect voice outcomes (P =.640). Conclusion: Patient- and provider-perceived voice quality are significantly improved after medialization laryngoplasty in the elderly, and the procedure is associated with a low complication rate even in an elderly cohort. Improvement in patient-perceived voice outcomes after medialization laryngoplasty was diminished in patients with preoperative injection augmentation.

Original languageEnglish (US)
Pages (from-to)876-884
Number of pages9
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume160
Issue number5
DOIs
StatePublished - May 1 2019

Keywords

  • elderly patients
  • glottic insufficiency
  • injection augmentation
  • medialization laryngoplasty
  • medialization thyroplasty
  • vocal fold atrophy
  • vocal fold paralysis

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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