Analysis of laryngeal framework surgery: 10-year follow-up to a national survey

• Published in: The Laryngoscope Vol. 120; no. 8; p. 1602
• Main Authors: Young, VyVy N, Zullo, Thomas G, Rosen, Clark A
• Format: Journal Article
• Language: English
• Published: United States 01.08.2010
• Subjects: Follow-Up Studies; Glottis - surgery; Health Care Surveys; Humans; Larynx - surgery; Otorhinolaryngologic Surgical Procedures - adverse effects; Otorhinolaryngologic Surgical Procedures - statistics & numerical data; Prosthesis Implantation - adverse effects; Prosthesis Implantation - statistics & numerical data; Vocal Cord Paralysis - surgery
• ISSN: 1531-4995
• DOI: 10.1002/lary.21004

Laryngeal framework surgery, including medialization laryngoplasty (ML) and arytenoid adduction (AA), are common treatments for vocal fold paralysis and glottal incompetence. Little information is known about the incidence of ML/AA surgery nationwide, in particular the success and complication rates. A 25-item questionnaire was mailed to 6,644 Board-certified otolaryngologists. The response rate was 25.7% (n = 1,707). Sixty-three percent perform ML and/or AA, representing 29,748 procedures. Experience with Silastic medialization implants has decreased over time, while utilization of other materials has increased. The overall complication rate was 15%, including 0.8% implant extrusion and 6% revision rates. The most common revision was placement of a larger implant (37% of all revisions). Airway compromise requiring intervention was observed in 2.2%, and suboptimal voice outcome in 4%. Although not statistically significant, a trend was observed of decreasing complication rate with increasing experience. Laryngeal framework surgeries are being performed with increasing frequency in the United States. The overall complication rate is slightly increased in the present study, but airway compromise and poor vocal outcome are decreased, and the need for revision surgery is unchanged. These findings suggest a continued high level of efficacy of these procedures.