Effect of Thyroplasty Type I Implant Location on Glottal Medial Shape During Phonation of a Canine Larynx Model
Résumé
Objectives / Introduction: Common operations for unilateral vocal fold paralysis (UVFP), such as Thyroplasty Type 1, improve vocal efficiency (VE) by closing the membranous gap between the normal and paralyzed fold. VE measures the degree to which subglottal aerodynamic power is translated to acoustic power. However, even after surgical treatment, some patients report symptoms such as vocal fatigue, decreased projection, and decreased intelligibility in noisy environments. These recalcitrant symptoms will be associated with reduced VE relative to normal voice, suggesting that enhancing VE could further ameliorate these symptoms.
Previous research in the excised canine larynx suggests that this further improvement is possible by certain modifications to the procedure. For example, it was found that medialization of the tissue below the fold (infraglottal region) results in higher VE than medialization of the fold itself (glottal) even though both operations close the mediallateral membranous gap 1,2 . However, translating these surgical findings in animals to patients requires a deeper understanding of how and why various treatment modifications affect VE. This study's goal is to quantify the effect of implant location on the stiffness gradient, maximum divergence angle, vocal fold vertical height, and vocal efficiency (VE) using an excised canine larynx model.
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