Pathophysiology and indications for medialization thyroplasty in patients with dysphagia and aspiration

Paul Flint, L. L. Purcell, C. W. Cummings

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Medialization thyroplasty is generally considered a phonosurgical procedure for voice augmentation in patients with glottic insufficiency. This article addresses specifically the issue of dysphagia and aspiration in patients with laryngeal paralysis. A retrospective review of patients undergoing medialization thyroplasty is performed. From 1991 to 1995, 84 patients at The Johns Hopkins Medical institutions underwent medialization thyroplasty for unilateral vocal fold motion impairment. At presentation 48 patients had isolated recurrent laryngeal nerve injury, 26 with combined superior laryngeal nerve/recurrent laryngeal nerve injury and 10 with idiopathic nerve injury. Sixty-one percent of patients had swallowing difficulties. The severity of symptoms is greater in the superior laryngeal nerve/recurrent laryngeal nerve group. Before surgery 13 patients were dependent on feeding tubes. Nine patients improved to the point at which all alimentation was taken by mouth and tube feedings were discontinued after medialization thyroplasty. One patient was subsequently converted to a full oral diet after cricopharyngeal myotomy. Three patients remained dependent on feeding tubes. The pathophysiology of dysphagia including clinical and experimental observations is reviewed. In addition, the nonsurgical and surgical approaches to treatment of patients with laryngeal paralysis are reviewed.

Original languageEnglish (US)
Pages (from-to)349-354
Number of pages6
JournalOtolaryngology - Head and Neck Surgery
Volume116
Issue number3
DOIs
StatePublished - 1997
Externally publishedYes

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Laryngoplasty
Deglutition Disorders
Enteral Nutrition
Recurrent Laryngeal Nerve Injuries
Laryngeal Nerves
Vocal Cord Paralysis
Recurrent Laryngeal Nerve
Vocal Cords
Deglutition
Tongue
Mouth

ASJC Scopus subject areas

  • Otorhinolaryngology

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Pathophysiology and indications for medialization thyroplasty in patients with dysphagia and aspiration. / Flint, Paul; Purcell, L. L.; Cummings, C. W.

In: Otolaryngology - Head and Neck Surgery, Vol. 116, No. 3, 1997, p. 349-354.

Research output: Contribution to journalArticle

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