Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients

Miaśkiewicz, Beata; Szkiełkowska, Agata; Gos, Elżbieta; Panasiewicz, Aleksandra; Włodarczyk, Elżbieta; Skarżyński, Piotr H.

doi:10.1007/s00405-018-5040-2

Cited by 25 publications

(17 citation statements)

References 35 publications

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“…The absence of improvement in the degree of roughness (R) may indicate that, in this sample, the gradation of the general grade of vocal deviation (G) decreased due to the reduction in the degree of deviation from other parameters on the GRBASI scale, such as, for example, tension and breathiness. 9,28,29,35 In addition, it is believed that the reduced number of individuals per pathology available for pre-and post-treatment comparison has also contributed to the lack of evidence of improvement in the degree of roughness of individuals in this sample. In general, it was possible to identify the improvement in vocal quality after treatment application, regardless of the subtype presented and the treatment performed.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the general impact of dysphonia, it is noted that only 8.1 and 7.4% of all subjects had, respectively, general degree and degree of roughness classified as extreme, regardless of the subtype of MSAC (►Table 2), confirming that the percentage of subjects classified with severe dysphonia in the auditory-perceptual analysis is reduced in the most common subtypes of MSAC. 9,28,29,35 Speech therapy treatment was performed at least 50% of the time in all subtypes of MSAC (►Table 3). It is worth mentioning then that the benefits brought by this therapy and the treatment phase in which it is most indicated are controversial.…”

Section: Discussionmentioning

confidence: 99%

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Minor Structural Alterations of the Vocal Fold Cover: Vocal Quality before and after Treatment

Brito

Silva

Moraes

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Minor structural alterations of the vocal fold cover are important causes of dysphonia. The variability in the type of alteration and the grade of vocal deviation affects the definition of the conduit and the results of treatment. Objective To characterize the occurrence, the selected treatments adopted and vocal quality before and after treatment in patients with minor structural alterations of the vocal folds cover. Methods This was a cross-sectional study based on the records of patients treated by an interdisciplinary team at the laryngology outpatient clinic of a public university hospital from 2010 to 2018. Data collection consisted of access to a database of information on otorhinolaryngological diagnostic hypotheses, intervention and perceptual-auditory vocal assessments before and after the treatment. Data from 102 subjects were analyzed. Association tests were applied between the perceptual-auditory vocal results and the different alterations found and between these and the adopted treatments. The results of the degrees of vocal deviation before and after treatment were also compared. Results The degree of roughness was associated with the sulcus vocalis, and in this alteration the highest occurrence was mild degree of roughness. There was an improvement in the breathiness and general grade of vocal deviation after treatment. Conclusion Cysts were the most frequent structural alteration in the population studied. There was an association between the degree of general deviation and that of roughness in sulcus vocalis cases. The breathiness and the general grade of vocal deviation improved after treatment regardless of the type of treatment and alteration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minor Structural Alterations of the Vocal Fold Cover: Vocal Quality before and after Treatment

Brito

Silva

Moraes

et al. 2020

Int Arch Otorhinolaryngol

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“…There was also significant improvement in the grade, roughness and breathiness of the GRBAS score, glottal closure and mucosal wave amplitude of the stroboscopic findings, and in most of the aerodynamic and acoustic parameters [ 29 ]. Miaskiewicz recently showed an improvement in the VHI-30 of 10.2 points (preoperative 44.36 versus postoperative 34.12) at 12 months after combined sulcus excision and VFI, using a short-acting filler in 29 cases, a long-acting filler in 2, a combination of fillers in 2, and no filler in 3 cases [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite their different surgical approaches to treat sulcus, the studies above show statistically significant and clinically relevant improvements in VHI scores, although these are still above normal [ 27 , 29 , 30 , 34 ]. It is important to note that these results are in line with our results from treating sulcus with autologous fat injection only.…”

Section: Discussionmentioning

confidence: 99%

Bilateral vocal fold injection with autologous fat in patients with vocal fold atrophy with or without sulcus

Broek

Heijnen

Hendriksma

et al. 2019

Eur Arch Otorhinolaryngol

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Purpose To evaluate voice outcome after bilateral vocal fold injection with autologous fat in patients with non-paralytic glottic insufficiency due to vocal fold atrophy with or without sulcus. Methods This is a retrospective cohort study from September 2012 to December 2017 including 23 patients undergoing bilateral vocal fold injection with autologous fat (24 procedures) for vocal fold atrophy (15 procedures) or atrophy with sulcus (Ford type II or III) (9 procedures). Voice data were collected and analyzed for the preoperative and the 3- and 12-month postoperative time points according to a standardized protocol, including Voice Handicap Index (VHI)-30 and perceptive, acoustic and aerodynamic parameters. Failure rate was defined as non-relevant improvement (< 10 points) in VHI-30 at 12 months and number of revisions within 12 months. Results There was a clinically relevant (≥ 15 points) and statistically significant improvement in the VHI-30 (preoperative: 49.1 points; postoperative at 12 months: 29.7 points). Change in dynamic range was also statistically significant over time ( p = 0.028). There were no differences in voice parameters between patients with atrophy only and atrophy with sulcus, although grade tended to be lower in patients with atrophy only over all time points. Conclusion This study shows that bilateral vocal fold injection with autologous fat is a beneficial treatment not only for patients with atrophy but also for patients with sulcus. A comparison of the results with those reported from other forms of sulcus surgery confirmed this finding. However, there is a need for further prospective studies comparing the short- and long-term effects of different techniques.

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“…Although, Miaśkiewicz et al 17 mentioned improvement in all parameters (glottal closure, mucosal wave, and amplitude) after sulcus vocalis injection. The author underwent surgical excision of fibrous bands, followed by VF injection augmentation.…”

Section: Voice Handicap Indexmentioning

confidence: 98%

Office-based Injection Laryngoplasty: Outcome after Hydroxylapatite Injection

Hassan¹

2019

International Journal of Phonosurgery &Amp; Laryngology

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Background: Office-based injection laryngoplasty is a surgical procedure that becomes more popular for vocal fold (VF) augmentation. Hydroxylapatite (Radiesse) is used to narrow the glottal gap in cases with glottal insufficiency. Objective: To assess voice outcome and patient's quality of life in selected group of dysphonic patients using office-based hydroxylapatite injection under local anesthesia in cases with glottal insufficiency. Materials and methods: Forty-one patients with different voice disorders, namely sulcus vocalis, unilateral VF immobility, and VF atrophy were selected. All patients underwent office-based injection of hydroxylapatite under local anesthesia. All patients were evaluated by using auditory perceptual analysis, laryngeal videostroboscope (LVS), acoustic analysis, and voice handicap index (VHI) preoperatively and 3 months postoperatively. Results: Improvement in glottal gap in all groups of patients was measured by LVS examination. Also, there was significant improvement in acoustic correlates of dysphonia, namely jitter%, shimmer%, noise to harmonic ratio (NHR), and maximum phonation time (MPT) in patients with unilateral VF immobility and VF atrophy. Also improved quality postinjection was reported in all groups measured by VHI. Conclusion:Office-based injection laryngoplasty with hydroxylapatite is a reliable and effective procedure in management of mild and moderate glottal gap because of unilateral VF immobility and VF atrophy.

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Pathological sulcus vocalis: treatment approaches and voice outcomes in 36 patients

Cited by 25 publications

References 35 publications

Minor Structural Alterations of the Vocal Fold Cover: Vocal Quality before and after Treatment

Minor Structural Alterations of the Vocal Fold Cover: Vocal Quality before and after Treatment

Bilateral vocal fold injection with autologous fat in patients with vocal fold atrophy with or without sulcus

Office-based Injection Laryngoplasty: Outcome after Hydroxylapatite Injection

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