The Impact of Endoscopic-Assisted Arytenoid Adduction Surgery on Phonation Disorder Voice Handicap

Conventional arytenoid adduction is often associated with a risk of perforating the piriform sinus, bleeding or edema of the larynx following airway obstruction. We designed a simple and less invasive method, Endoscopicassisted Arytenoid Adduction Surgery (EAAS), for unilateral vocal fold paralysis (UVFP), in which we employ a looped traction nylon thread under laryngeal endoscopic guidance. We reported that our phonation analysis date thus far has indicated the efficacy of EAAS and that no major complications such as airway obstruction have occurred. As it is truly important to evaluate how patients personally perceive their benefits, we now evaluate them using an objective index such as Japanese versions of voice handicap index (VHI) and singing voice handicap index (SVHI). We retrospectively examined 14 patients with UVFP for the following measurements: maximum phonation time (MPT), mean air flow rate (MFR), and three acoustic analysis parameters which were measured before and after EAAS. Ten of them answered the VHI and SVHI questionnaires. Postoperatively, VHI score significantly improved from their preoperative values, but SVHI have not done so. Statistical correlations were seen between VHI and MPT or MFR. These results suggest the validity of EAAS from the perspective of the voice handicap of phonation disorder.