Multi-institutional Evaluation of Medialization Laryngoplasty in the Elderly.

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Multi-institutional Evaluation of Medialization Laryngoplasty in the Elderly.

Otolaryngol Head Neck Surg. 2018 Dec 11;:194599818817762

Authors: Philips R, Chorath K, DeSilva B, Forrest LA, Simpson CB, Matrka L

Abstract
OBJECTIVE: To evaluate voice outcomes of medialization laryngoplasty in the elderly population (65 years and older) and to identify swallow outcomes, complication rates, and predictors of voice outcomes.
STUDY DESIGN: Case series with chart review.
SETTING: Two tertiary academic medical centers.
SUBJECTS AND METHODS: We retrospectively reviewed charts of 136 patients age 65 years and older undergoing medialization laryngoplasty between January 2008 and May 2016 at 2 tertiary academic institutions. Primary outcome was assessed using Voice Handicap Index 10 (VHI-10) score and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) score. Secondary outcomes were assessed using the Eating Assessment Tool 10 (EAT-10) when dysphagia was present, stroboscopic analysis of glottic closure, and complication rates. A logistic regression analysis assessed predictors of voice improvement after medialization laryngoplasty.
RESULTS: Total GRBAS and VHI-10 scores showed a significant improvement postoperatively ( P < .05). A ≥20% improvement was seen in 81.6% of patients, and a ≥50% improvement was seen in 53.7%. No patient had major complications. Minor complications occurred in 5.9% of patients. Multivariable logistic regression identified preoperative injection augmentation as an independent predictor of less improvement in VHI-10 score ( P = .015). Voice therapy prior to medialization did not affect voice outcomes ( P = .640).
CONCLUSION: Patient- and provider-perceived voice quality are significantly improved after medialization laryngoplasty in the elderly, and the procedure is associated with a low complication rate even in an elderly cohort. Improvement in patient-perceived voice outcomes after medialization laryngoplasty was diminished in patients with preoperative injection augmentation.

PMID: 30526322 [PubMed - as supplied by publisher]

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