Type I Thyroplasty in Previously Irradiated Patients

Abstract

Objectives (1) Review and report our experience performing medialization thyroplasty (MT) in previously irradiated patients and (2) compare complications and voice outcomes in 2 cohorts (irradiated vs nonradiated) to evaluate safety and efficacy. Study Design Case series with chart review. Setting Academic medical center. Subjects All patients (44 total) who underwent MT from 2011 to 2015. Methods Demographic data, complications, and acoustic and subjective voice outcome parameters were collected. The complication rates and voice outcome results were compared between 2 cohorts: patients with a history of radiation to the neck versus those with no radiation history. Results There were 7 previously irradiated patients and 37 nonradiated patients, with median follow-up of 314 and 538 days, respectively. One complication was noted in each group, and this complication rate was not significantly different ( P = .26). Both cohorts demonstrated significant postoperative improvement in subjective voice assessment ( P = .04, P < .0001) as well as maximum phonation time ( P = .02, .001) when compared with preoperative data. Conclusions Our study suggests that MT can be safely and effectively performed in irradiated patients. We found no statistically significant difference in the safety of performing MT in irradiated versus nonradiated patients, and there was significant improvement in subjective voice parameters and maximum phonation time in both groups. A larger prospective study is required to statistically determine whether the significant improvements in objective parameters seen in the nonradiated group are present in irradiated patients as well.