Summary
Objectives
Voice production in pathological conditions or after surgical intervention often involves
undesired medial surface shape such as reduced vertical thickness and/or left-right
asymmetry in medial surface shape. The effect of such undesired medial surface on
voice production remains unclear, and is often not taken into consideration during
planning of surgical intervention, due to difficulty of imaging the medial surface
in patients. This study aims to better understand how voice outcomes are impacted
by undesired medial surface shape.
Methods
Computational simulations were conducted to parametrically manipulate medial surface
shape and stiffness and observe its consequence on voice production.
Results
The results showed that undesired medial surface shape can result in incomplete glottal
closure, weak voice production, increased phonation threshold, and significantly reduced
vocal efficiency, particularly in the presence of left-right stiffness asymmetry.
Conclusions
In addition to approximating the vocal folds, medialization laryngoplasty should aim
to sufficiently increase medial surface thickness, which may improve voice outcomes
in patients whose voices remain unsatisfactory or suboptimal after initial intervention.
While a divergent implant may increase medial surface thickness, precise implant placement
in anticipation of tissue and implant deformation during the insertion process is
equally important in order to achieve desired medial surface shape and optimal voice
outcomes.
Key Words
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Article info
Publication history
Published online: April 08, 2022
Accepted:
March 10,
2022
Publication stage
In Press Corrected ProofFootnotes
This study was supported by research Grant Nos. R01DC009229 and R01DC001797 from the National Institute on Deafness and Other Communication Disorders, the National Institutes of Health.
Identification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
