"Treatment effectiveness for aging changes in the larynx" by Aaron M. Sachs, Steven A. Bielamowicz et al.
 

Treatment effectiveness for aging changes in the larynx

Document Type

Journal Article

Publication Date

11-1-2017

Journal

Laryngoscope

Volume

127

Issue

11

DOI

10.1002/lary.26706

Keywords

injection augmentation; Presbylarynges; presbyphonia; thyroplasty

Abstract

© 2017 The American Laryngological, Rhinological and Otological Society, Inc. Objectives: To compare the effectiveness of injection augmentation and bilateral thyroplasty surgery in managing age-related changes of the larynx. Study Design: Retrospective chart review of patients treated with bilateral thyroplasty and/or injection augmentation. Methods: We evaluated 22 patients before and after treatment using: 1) normalized glottal gap area and normalized true vocal fold width from endoscopic images; 2) patient self-rating questionnaires; and 3) acoustic and aerodynamic measures. Results: Thyroplasty surgery resulted in 38% of patients demonstrating less bowing compared to 33% after injection, and 63% demonstrated less supraglottic activity compared to 43% after injection (P = 0.09). Change in mean Voice-Related Quality of Life (V-RQOL) scores was 25.5 after thyroplasty compared to −16.4 after injection (P < 0.05). Those exhibiting a greater than 20 change in V-RQOL after treatment were significantly more likely to report swallowing symptoms pretreatment. Conclusion: Patients postinjection did not rate themselves on any questionnaires as significantly better compared to pretreatment, whereas patients post-thyroplasty rated themselves as significantly improved on all questionnaires. Patients post-thyroplasty rated their voices as significantly closer to their best voice than patients postinjection. Likewise, 64% of patients who had thyroplasty surgery reported a significant treatment effect compared to 33% for injection augmentation. Level of Evidence: 4. Laryngoscope, 127:2572–2577, 2017.

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