Voice outcome following thyroplasty in patients with cancer-related vocal fold paralysis

Medialization laryngoplasty restores voice in patients with unilateral lary ngeal paralysis. Of question was whether patients with vocal fold paralysis resulting from cancer or its treatment had as good a post-operative voice result as patients with vocal fold paralysis of benign etiology. The purpos e of the present study was to compare post-operative perceptual. acoustic, aerodynamic, and quality of life data in these two patient groups. Twenty-e ight patients with vocal fold paralysis secondary to malignancy or its trea tment were age and gender-matched with patients with paralysis resulting fr om benign origin. Pre- and post-operative perceptual judgments of pitch, lo udness and quality were rated independently by two speech-language patholog ists. A digital audiotape of the patient's voice was analyzed using Soundsc ope software, Fundamental frequency, conversational intensity and perturbat ion were evaluated. Glottal flow rates in propositional speech., phonation times and extent of pitch and loudness ranges were also measured. Three qua lity of life surveys, the Short Form-36 general health survey, the Voice Ha ndicap Index. and the Voice Outcomes Study were administered. Results of vo ice testing indicated that perceptual. acoustic and aerodynamic data were s ignificantly improved 3 months after thyroplasty in all patients regardless of whether they had a history of cancer. Quality of life data, however, di stinguished the two groups. ln particular, the general health measure found a significant difference in physical functioning and overall vitality, alt hough satisfaction with improved voice was equally appreciated in both pati ent groups. Of clinical significance is that though general health may diff er, patients with cancer-related laryngeal paralysis can expect to have as good a voice outcome following thyroplasty as patients with paralysis of be nign etiology. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.