Voice assessment of fat injection vs medialization laryngoplasty in nonparalytic dysphonia

• Published in: Laryngoscope investigative otolaryngology Vol. 6; no. 3; pp. 453 - 457
• Main Authors: Rapoport, Sarah K., Murry, Thomas, Woo, Peak
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.06.2021; Wiley
• Subjects: Age; Demographics; Etiology; fat injection medialization; LARYNGOLOGY, SPEECH AND LANGUAGE SCIENCE; medialization laryngoplasty; Medical records; nonparalytic dysphonia; Original Research; Paresis; Patients; Perceptions; VHI‐10; VHI‐10; nonparalytic dysphonia; fat injection medialization; medialization laryngoplasty
• ISSN: 2378-8038; 2378-8038
• DOI: 10.1002/lio2.573

Objective Compare long‐term voice outcomes in patients treated with FIM or BML for nonparalytic dysphonia. There is controversy whether fat injection medialization (FIM) is a durable alternative to bilateral medialization laryngoplasty (BML) for nonparalytic dysphonia (atrophy, sulcus, scar, paresis). Both interventions yield improved voice quality, yet comparison of patients' long‐term perceptions of their voice after these procedures has not been performed. Methods Retrospective review of patients who underwent FIM or BML for nonparalytic dysphonia was performed from 2008‐2018. Charts were reviewed for demographic information, preoperative diagnosis, intervention, Voice Handicap Index‐10 (VHI‐10), and follow‐up time. Results Forty‐nine patients met our criteria. Fifty procedures were performed (25 FIM, 25 BML). One patient underwent BML with subsequent FIM. There was no significant difference in pre‐treatment or post‐treatment VHI‐10 scores between both groups (Pre‐FIM 21 Post‐FIM 10.28; Pre‐BML 22.48, Post‐BML 10.88). Total median follow‐up time was 11.3 months (FIM 14.8 months, BML 9.5 months). Using VHI‐10 scores recorded at each patient's latest follow‐up visit, both groups demonstrated significant decrease (P < .05) compared to preoperative scores: VHI‐10 decreased by a mean delta of 10.72 in the FIM group and 11.6 in the BML group. There was no significant difference in pre, post and change in VHI between groups. Conclusions In patients with nonparalytic dysphonia, FIM is a durable alternative to BML. Patients treated in both groups gained substantial improvement in vocal function. For both treatment groups, we should anticipate less than complete satisfaction with surgery and revision procedures in a minority of patients. Level of Evidence IV. There is controversy whether fat injection medialization is a durable alternative to bilateral medialization laryngoplasty for non‐paralytic dysphonia (atrophy, sulcus, scar, paresis). Yet comparison of patients' long‐term perceptions of their voice after these procedures has not been performed. In this study we compare long‐term voice outcomes in patients treated with fat injection medialization or bilateral medialization laryngoplasty for non‐paralytic dysphonia.