Type I Thyroplasty in Previously Irradiated Patients: Assessing Safety and Efficacy

• Published in: Otolaryngology-head and neck surgery Vol. 153; no. 4; p. 582
• Main Authors: Rosow, David E, Al-Bar, Mohammad H
• Format: Journal Article
• Language: English
• Published: England 01.10.2015
• Subjects: Female; Follow-Up Studies; Humans; Laryngoplasty - methods; Male; Middle Aged; Neck - radiation effects; Phonation; Postoperative Complications; Treatment Outcome; Voice; framework surgery; Gore-Tex; thyroplasty; medialization thyroplasty; complications; radiation; vocal fold paralysis; laryngeal framework surgery; laryngoplasty
• ISSN: 1097-6817
• DOI: 10.1177/0194599815599970

(1) Review and report our experience performing medialization thyroplasty (MT) in previously irradiated patients and (2) compare complications and voice outcomes in 2 cohorts (irradiated vs nonradiated) to evaluate safety and efficacy. Case series with chart review. Academic medical center. All patients (44 total) who underwent MT from 2011 to 2015. Demographic data, complications, and acoustic and subjective voice outcome parameters were collected. The complication rates and voice outcome results were compared between 2 cohorts: patients with a history of radiation to the neck versus those with no radiation history. There were 7 previously irradiated patients and 37 nonradiated patients, with median follow-up of 314 and 538 days, respectively. One complication was noted in each group, and this complication rate was not significantly different (P = .26). Both cohorts demonstrated significant postoperative improvement in subjective voice assessment (P = .04, P < .0001) as well as maximum phonation time (P = .02, .001) when compared with preoperative data. Our study suggests that MT can be safely and effectively performed in irradiated patients. We found no statistically significant difference in the safety of performing MT in irradiated versus nonradiated patients, and there was significant improvement in subjective voice parameters and maximum phonation time in both groups. A larger prospective study is required to statistically determine whether the significant improvements in objective parameters seen in the nonradiated group are present in irradiated patients as well.