Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Archives of Oto-Rhino-Laryngology
Published in: European Archives of Oto-Rhino-Laryngology 7/2013

01-07-2013 | Laryngology

Medialization thyroplasty for voice restoration after transoral cordectomy

Authors: Nicholas S. Mastronikolis, Marc Remacle, Debora Kiagiadaki, George Lawson, Vincent Bachy, Sebastien Van Der Vorst

Published in: European Archives of Oto-Rhino-Laryngology | Issue 7/2013

Login to get access

Abstract

Fourteen dysphonic patients who had previously undergone total or extended cordectomy underwent medialization thyroplasty. A minimum delay of 6 months was respected to allow the spontaneous “neocord” formation, to evaluate the voice recovery achieved by speech therapy alone and to avoid an undiagnosed early recurrence. Surgery was performed under general anaesthesia, using a laryngeal mask, because undermining the fibrous tissue at the inner side of the thyroid ala is a prolonged and difficult procedure. This step was essential to ensure an easy placement of the implant and to avoid tearing the fibrous tissue, with subsequent risk of implant extrusion. Visual control of the implant implementation was obtained by flexible videoendoscopy. The Montgomery® implant system (Boston, Westborough, MA) was used for the majority of the cases. Hand-made modified Montgomery implants or Gore-tex® were used in case of extended scarring or peculiar anatomic defect. The voice assessment showed a decrease of the VHI score from 50.5 to 39.4; a decrease of G from 2.4 to 2; an increase of maximum phonation time (MPT) from 6.2 to 7.3 s; a decrease of the maximum fundamental frequency (Fo-high) from 338.7 to 242.4 Hz and a decrease of the phonation quotient from 1,144.9 to 544.9 ml/s. The lower intensity (I-low) remained unchanged, from 60 to 58 dB. Statistically significant improvement was noted only for VHI and G grading. A decrease of the voice efforts and fatigue were noticed by all the patients.
Literature
1.
Remacle M, Lawson G, Jamart J, Minet M, Watelet JB, Delos M (1997) CO2 laser in the diagnosis and treatment of early cancer of the vocal fold. Eur Arch Otorhinolaryngol 254:169–176PubMedCrossRef
2.
Damm M, Sittel C, Streppel M et al (2000) Transoral CO2 laser for surgical management of glottic carcinoma in situ. Laryngoscope 110(7):1215–1221PubMedCrossRef
3.
Silver CE, Beitler JJ, Shaha AR, Rinaldo A, Ferlito A (2009) Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorhinolaryngol 266:1333–1352PubMedCrossRef
4.
Peretti G, Nicolai P, De Zinis LOR et al (2000) Endoscopic CO2 laser excision for Tis, T1, and T2 glottic carcinomas: cure rates and prognostic factors. Otolaryngol Head Neck Surg 123:124–131PubMedCrossRef
5.
Goor KM, Peeters AJGE, Mahieu HF, Langendijk JAD, Leemans CR, Verdonck-de Leeuw IM, van Agthoven M (2007) Cordectomy by CO2 laser or radiotherapy for small T1a glotttic carcinomas: costs, local control, survival, quality of life and voice quality. Head Neck 2:128–136CrossRef
6.
Morris MR, Canonico D, Blank C (1994) A critical review of radiotherapy in the management of T1 glottic carcinoma. Am J Otolaryngol 15(4):276–280PubMedCrossRef
7.
Delsupehe KG, Zink I, Lejaegere M, Bastian RW (1999) Voice quality after narrow-margin laser cordectomy compared with laryngeal irradiation. Otolaryngol Head Neck Surg 121:528–533PubMedCrossRef
8.
Sittel C, Eckel HE, Eschenburg C (1998) Phonatory results after laser surgery for glottic carcinoma. Otolaryngol Head Neck Surg 119:418–424PubMedCrossRef
9.
Peretti G, Piazza C, Balzanelli C, Mensi MC, Rossini M, Antonelli AR (2003) Preoperative and postoperative voice in Tis-T1 glottic cancer treated by endoscopic cordectomy: an additional issue for patient counseling. Ann Otol Rhinol Laryngol 112:759–763PubMed
10.
Remacle M, Eckel HE, Antonelli A, Brasnu D, Chevalier D, Friedrich G, Olofsson J, Rudert HH, Thumfart W, de Vincentiis M, Wustrow TPU (2000) Endoscopic cordectomy. A proposal for a classification by the Working Committee European Laryngological Society. Eur Arch Otorhinolaryngol 257:227–231PubMedCrossRef
11.
Remacle M, Lawson G, Hedayat A, Trussart C, Jamart J (2001) Medialization framework surgery for voice improvement after endoscopic cordectomy. Eur Arch Otorhinolaryngol 258:267–271CrossRef
12.
Zeitels SM, Jarboe J, Franco RA (2001) Phonosurgical reconstruction of early glottic cancer. Laryngoscope 111:1862–1865PubMedCrossRef
13.
Remacle M, Lawson G, Morsomme D, Jamart J (2006) Reconstruction of glottic defects after endoscopic cordectomy: voice outcome. Otolaryngol Clin North Am 39:191–204PubMedCrossRef
14.
Piazza C, Villaret AB, De Zinis L, Cattaneo A, Cocco D, Peretti G (2007) Phonosurgery after endoscopic cordectomies. II. Delayed medialization techniques for major glottic incompetence after total and extended resections. Eur Arch Otorhinolaryngol 264:1185–1190PubMedCrossRef
15.
Remacle M, Van Haverbeke C, Eckel H, Bradley P, Chevalier D, Djukic V, de Vicentiis M, Friedrich G, Olofsson J, Peretti G, Quer M, Werner J (2007) Proposal for revision of the European Laryngological Society classification of endoscopic cordectomies. Eur Arch Otorhinolaryngol 264:499–504PubMedCrossRef
16.
Friedrich G, de Jong F, Mahieu HF, Benninger MS, Isshiki N (2001) Laryngeal framework surgery: a proposal for classification and nomenclature by the Phonosurgery Committee of the European Laryngological Society. Eur Arch Otorhinolaryngol 258:389–396PubMedCrossRef
17.
Cummings CW, Purcell LL, Flint PW (1993) Hydroxylapatite laryngeal implants for medialization. Preliminary report. Ann Otol Rhinol Laryngol 102:843–851PubMed
18.
Zeitels SM, Mauri M, Dailey SH (2003) Medialization laryngoplasty with Gore-Tex for voice restoration secondary to glottal incompetence: indications and observations. Ann Otol Rhinol Laryngol 112(2):180–184PubMed
19.
Montgomery WW, Montgomery SK (1997) Montgomery thyroplasty implant system. Ann Otol Rhinol Laryngol Suppl 170:1–16
20.
Lichtenberger G, Toohill RJ (1994) New keel fixing technique for endoscopic repair of anterior commissure webs. Laryngoscope 104(6 Pt 1):771–774PubMed
21.
DeJonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchman L, Friedrich G, Van de Heyning P, Remacle M, Woisard V (2001) A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Guidelines elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 258:77–82PubMedCrossRef
22.
Jacobson BH, Johnson A, Grywalsky C, Silbergleit A, Jacobson G, Benninger MS, Newman CW (1997) The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol 6:66–70
23.
Hirano M (1981) Clinical examination of voice. Springer, New York
24.
Isshiki N, Morita H, Okamura H, Hiramoto M (1974) Thyroplasty as a new phonosurgical technique. Acta Otolaryngol (Stockh) 78:451–457CrossRef
25.
Ford CN, Bless DM (1993) Selected problems treated by vocal fold injection of collagen. Am J Otolaryngol 14:257–261PubMedCrossRef
26.
Remacle M, Lawson G, Keghian J, Jamart J (1999) Use of injectable autologous collagen for correcting glottic gaps: initial results. J Voice 13:280–288PubMedCrossRef
27.
Hirano M, Tanaka S, Tanaka Y, Hibi S (1990) Transcutaneous intrafold injection for unilateral vocal fold paralysis: functional results. Ann Otol Rhinol Laryngol 99:598–604PubMed
28.
Zaretsky LS, Shindo ML, deTar M, Rice DH (1995) Autologous fat injection for vocal fold paralysis: long-term histologic evaluation. Ann Otol Rhinol Laryngol 104:1–4PubMed
29.
Ersek RA, Gregory SR, Salisbury AV (1997) Bioplastique at 6 years: clinical outcome studies. Plast Reconstr Surg 100:1570–1574PubMedCrossRef
30.
Friedrich G (1999) Titanium vocal fold medializing implant: introducing a novel implant system for external vocal fold medialization. Ann Otol Rhinol Laryngol 108(1):79–86PubMed
31.
Sittel C, Friedrich G, Zorowka P, Eckel HE (2002) Surgical voice rehabilitation after laser surgery for glottic carcinoma. Ann Otol Rhinol Laryngol 111:493–499PubMed
32.
Peretti G, Piazza C, Bolzoni A, Mensi MC, Rossini M, Parrinello G, Shapshay SM, Antonelli AR (2004) Analysis of recurrences in 322 Tis, T1, or T2 glottic carcinomas treated by carbon dioxide laser. Ann Otol Rhinol Laryngol 113:853–858PubMed
33.
Laccourreye O, El Sharkawy L, Holsinger C, Hans S, Menard M, Brasnu D (2005) Thyroplasty type I with Montgomery implant among native French language speakers with unilateral laryngeal nerve paralysis. Laryngoscope 115:1411–1417PubMedCrossRef
Metadata
Title
Medialization thyroplasty for voice restoration after transoral cordectomy
Authors
Nicholas S. Mastronikolis
Marc Remacle
Debora Kiagiadaki
George Lawson
Vincent Bachy
Sebastien Van Der Vorst
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
European Archives of Oto-Rhino-Laryngology / Issue 7/2013
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-013-2462-8

Other articles of this Issue 7/2013

European Archives of Oto-Rhino-Laryngology 7/2013 Go to the issue

Review Article

Timely recanalization of lateral sinus thrombosis in children: should we consider hypoplasia of contralateral sinuses in treatment planning?

Otology

Hyperventilation-induced nystagmus in vestibular schwannoma and unilateral sensorineural hearing loss

Rhinology

The Wexham Criteria: defining severe epistaxis to select patients requiring sphenopalatine artery ligation

Otology

The evaluation of ozone and betahistine in the treatment of tinnitus

Case Report

Successful surgical repair of complex Christmas-tree pattern tracheo-bronchial anatomy with stenosis

Head and Neck

Is sonoelastography a helpful method for evaluation of parotid tumors?