Thyrohyoid Approach for Vocal Fold Augmentation

Abstract

Objectives: I performed a retrospective chart review to evaluate the patient tolerance and clinical results of a new technique for office-based vocal fold augmentation. Methods: Ten patients undergoing the thyrohyoid approach for vocal fold augmentation were asked to rate their tolerance of the procedure using a 10-point rating scale (1 = “no problem” and 10 = “very uncomfortable”). The patients also filled out a quality-of-life survey (Voice Handicap Index-10) immediately before and 1 month after the procedure. I reviewed the preprocedure and postprocedure stroboscopic findings. The findings analyzed included changes in wave symmetry and glottal closure, and evidence of implant migration. Results: All patients successfully underwent the procedure. The mean patient tolerance score was found to be 2.1. The average score on the Voice Handicap Index-10 improved from 21.3 before the procedure (SD, 9.23) to 7.5 after the procedure (SD, 5.77). These values were compared by use of a paired t-test, and the difference was found to be significant, with a p value of .01. The analysis of stroboscopic results revealed “improvement” or “no change” in the wave symmetry, “improvement” in glottal closure, and “no evidence of migration” after the procedure in all cases. Conclusions: The study findings demonstrate that the thyrohyoid approach can be used successfully in patients who need vocal fold augmentation, and that it is generally well tolerated.