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Dana M. Hartl, MD, PhD; Stéphane Hans, MD, PhD; Jacqueline Vaissière, PhD; Daniel F. Brasnu, MD

Arch Otolaryngol Head Neck Surg. 2005;131:696-700.

Objective  To analyze laryngeal aerodynamics in the same patient in 4 different circumstances: before the onset of unilateral vocal fold paralysis (UVFP), after the onset of UVFP, and after 2 types of surgical vocal fold medialization techniques to compare the results of surgery with the measurements made in that same patient when his larynx was healthy (before paralysis).

Design  Prospective self-paired study of 1 male patient. Measurements were taken before iatrogenic UVFP (of the patient’s healthy larynx), 1 week after the onset of iatrogenic UVFP (thoracic surgery), 3 days after vocal fold medialization with autologous fat, and 2 months after polytetrafluoroethylene thyroplasty.

Setting  University hospital.

Main Outcome Measure  Phonatory airflow and intraoral pressure.

Results  Airflow and intraoral pressure increased after the onset of UVFP. Airflow decreased to preparalytic values after both types of vocal fold medialization. Intraoral pressure decreased after fat injection but increased after thyroplasty, despite the favorable effects of this treatment on laryngeal resistance and vocal efficiency compared with preparalytic values.

Conclusions  Our study demonstrates the variability of intraoral pressure as an indirect measure of subglottal pressure after vocal fold medialization in UVFP, due to as yet unknown factors. Phonatory airflow, laryngeal resistance, and vocal efficiency seem to be more reliable indicators of aerodynamic results after vocal fold medialization.

Author Affiliations: Voice, Biomaterials, and Head and Neck Oncology Research Laboratory, European Hospital Georges Pompidou, Paris, France (Drs Hartl, Hans, and Brasnu); Department of Otolaryngology and Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France (Dr Hartl); and Laboratoire de Phonétique et de Phonologie, Paris (Drs Hartl, Hans, and Vaissière).

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