Vocal Fold Atrophy and its Surgical Treatment

TLDR

The study emphasizes that intraoperative decision‑making, guided by voice quality, fiberoptic and manual tests, is essential for achieving optimal vocal outcomes. The authors performed type I thyroplasty, often combined with type III, on 31 patients (34 operations), using a firmly fixed silicone shim and generally overcorrecting to treat vocal‑fold atrophy. Surgery improved voice quality and ease of phonation, produced no complications, but yielded less satisfactory results when scar or sulcus was present, and patients valued the increased ease of phonation more than the quality improvement.

Abstract

The effectiveness of surgical treatment for vocal fold atrophy of various causes was examined. Type I thyroplasty was performed on 31 patients with vocal fold atrophy, often bilaterally and occasionally combined with type III thyroplasty. Of these 31 patients, 3 patients underwent the operation twice, for a total of 34 operations. The surgery was found to be effective in improving the voice quality and the ease of phonation. When a scar or sulcus was present, the results were not as satisfactory. The intraoperative decision-making process as to which procedure to perform is extremely important for achieving an optimal voice, and should be based on the intraoperative voice quality, fiberoptic findings, and manual tests. In operations for vocal fold atrophy in which the vocal folds are mobile, a silicone shim should be firmly fixed to prevent migration. Overcorrection is generally recommended. No complications were encountered. It was often the increased ease of phonation rather than the improved voice quality that patients appreciated after surgery.