Summary
Purpose
Medialization laryngoplasty can be performed to treat glottic incompetence after endoscopic
laser cordectomy. The aim of this study is to evaluate vocal outcome after this phonosurgical
procedure and to analyze the critical aspects of the Montgomery and Gore-Tex laryngoplasty
technique.
Methods
A retrospective observational study of patients with glottic incompetence after endoscopic
laser cordectomy, underwent medialization laryngoplasty with Montgomery or Gore-Tex
implant between January 2013 to December 2018 at the Bufalini Hospital of Cesena,
Italy. The pre- and postphonosurgery evaluation included videolaryngostroboscopy,
perceptual, evaluation of dysphonia with the GRBAS (grade, roughness, breathiness,
asthenia, strain) scale, Voice Handicap Index-10, Maximum Phonation Time. The outcome
was evaluated 6 months after the phonosurgical treatment.
Results
We treated 22 patients, 19 males and 3 females. Eight cases were treated with Montgomery
implant and fourteen with Gore-Tex implant. The postphonosurgical videolaryngostroboscopy
showed an improvement of the glottic closure in all patients; the scores of the Voice
Handicap Index-10 and of the Maximum Phonation Time showed a statistically significant
improvement after phonosurgery. The GRBAS scale scores showed a statistically significant
improvement of Global Grade, Breathiness, and Asthenia; the parameter Strain remained
unaltered both in pre- and postoperative evaluations, because the voice was never
pressed due to glottic insufficiency, especially in preoperative observation. The
parameter Roughness (R) did not show a significant difference between pre- and postoperative
evaluation.
Conclusion
Medialization laryngoplasty is an effective phonosurgical procedure to improve voice
outcome, after extended endoscopic laser cordectomies, in patients with unacceptable
results after voice therapy and injection laryngoplasty. In our experience the Gore-Tex
implant allows the surgeon to perform a safer and more “tailored” phonosurgery in
cases of cordectomies type IV and V, associated or not with radiotherapy and in revision
surgery.
Key words
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Article info
Publication history
Published online: October 26, 2020
Accepted:
October 6,
2020
Footnotes
Level of Evidence: IV.
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
