Very long‐term Voice Handicap Index Voice Outcomes after Montgomery Thyroplasty: A cross‐sectional study

• Published in: Clinical otolaryngology Vol. 43; no. 4; pp. 1097 - 1103
• Main Authors: Desuter, G., Zapater, E., Vorst, S., Henrard, S., Lith‐Bijl, J.T., Benthem, P.P., Sjögren, E.V.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.08.2018
• Subjects: Age differences; Cross-sectional studies; dysphonia; Gender aspects; medical education; Otolaryngology; outcomes quality of life; Paralysis; Patients; phoniatrics; Prostheses; Prosthetics; Sex differences; Surgery; Voice
• ISSN: 1749-4478; 1749-4486
• DOI: 10.1111/coa.13113

Objective The aim of this multicentric cross‐sectional study was to examine the permanency of Montgomery thyroplasty (MTIS) results from a patient's perspective. Design The study consisted of collecting Voice Handicap Index (VHI‐30) questionnaires from patients who had previously been operated with MTIS between 2 and 12 years before. Very long‐term (>2 years) postoperative data were compared with the previously acquired preoperative and early postoperative VHI results. Influence of factors such as age, gender, size/side of the prosthesis and length of the follow‐up were also analysed. Setting Multicentric study involving three tertiary European voice centres. Participants Forty‐nine unilateral vocal fold paralysis (UVFP) patients, treated by MTIS, were included in the study. Main outcome measures The Voice Handicap Index‐30 score. Results & Conclusions The median VHI was significantly different over time‐points (Friedman's test P < .001), with a significant difference between preoperative and early postoperative time‐points (median VHI: 70 vs 21, respectively; P < .001) and between preoperative and very long‐term postoperative time‐points (median VHI: 70 vs 16, respectively; P < .001). The median VHI did not differ for the early and very long‐term postoperative time‐points (median VHI: 21 vs 16; P = .470). Age differences, gender differences and size/side differences of the prostheses, centres where surgery took place and length of the follow‐up showed no significant influence. Medialisation thyroplasty (MT) overall and MTIS, in particular, should be considered as a possible standard of care for UVFP when permanency of voice results is sought.