Efficacy of Additional Injection Laryngoplasty after Framework Surgery

Abstract

Objectives: The purpose of this study was to clarify the efficacy of additional injection laryngoplasty (AIL) after framework surgery (FS), while also trying to identify which patients or procedures were more likely to require AIL to obtain optimal results and to clarify why. Methods: Fifty-two patients with unilateral vocal fold paralysis underwent FS (thyroplasty [TP], 23; arytenoid adduction [AA], 18; and AA with TP, 11). The numbers of patients who required AIL were calculated for each type of FS. The voice function after AIL was investigated. Thereafter, the width and the bowing ratios on phonation were measured in patients who underwent AA. Results: The patients who underwent AA required AIL more frequently than did patients who underwent TP. Use of AIL provided better voice function for all patients. The width ratio after AA decreased in all cases, but the bowing ratio increased after AA in 44% of cases. Conclusions: These results indicate that AIL is an effective treatment for patients who still have a glottal gap after undergoing FS. In particular, patients who had AA frequently required AIL, in comparison to patients who had TP, because of the high frequency of an increased bowing ratio after AA.