PMID- 25643933
OWN - NLM
STAT- MEDLINE
DCOM- 20150804
LR  - 20150520
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 125
IP  - 6
DP  - 2015 Jun
TI  - Permanent transoral surgery of bilateral vocal fold paralysis: a prospective 
      multi-center trial.
PG  - 1401-8
LID - 10.1002/lary.25137 [doi]
AB  - OBJECTIVES/HYPOTHESIS: To describe postoperative adverse events (AEs) and 
      outcomes after transoral surgery for bilateral vocal fold paralysis (BVFP). STUDY 
      DESIGN: Prospective observational multicenter study. METHODS: Thirty-six patients 
      with BVFP underwent transoral surgery using standard surgical procedures to 
      unilaterally widen the glottic area. Postoperative adverse events (AEs) including 
      severe adverse events (SAEs) were registered continuously. Pre- and 6-month 
      postoperative evaluations included the 6-Minute Walk Test, the 36-Item Short Form 
      Health Survey (SF-36), the Glasgow Benefit Inventory, the 12-Item Voice Handicap 
      Index (VHI-12), and a Fiberoptic Endoscopic Evaluation of Swallowing graded 
      according to the Penetration-Aspiration-Scale. RESULTS: The patients underwent 
      posterior cordotomy, partial arytenoidectomy, or permanent laterofixation as 
      single procedures or in combination. Forty-seven percent of the patients had 
      postoperative AEs. Dyspnea was the most frequent AE (45%). In 40% of AEs, the 
      events were severe (SAEs), and 72.5% were related to the study intervention. 
      Revision surgery leading to prolonged hospitalization or rehospitalization was 
      necessary in nine cases (25%). Laterofixation was correlated to a decreased risk 
      of AEs (P = 0.042). Six months after surgery, a significant improvement was seen 
      in the SF-domains: Physical component score (P = 0.008), physical functioning 
      (P = 0.001), physical role (P = 0.031), and vitality (P = 0.032). Concerning the 
      voice handicap, only the VHI-12 physical subscore showed a decrease (P = 0.005). 
      The total score and other VHI-12 subscores did not change significantly (all 
      P > 0.05). CONCLUSION: BCVP patients profit from modern transoral surgery for 
      unilateral glottic widening; quality of life is improved; and the voice is 
      preserved. Nevertheless, postoperative complications are frequent. LEVEL OF 
      EVIDENCE: 2b.
CI  - (c) 2015 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Nawka, Tadeus
AU  - Nawka T
AD  - Department of Audiology and Phoniatrics, Charite University Medicine Berlin, 
      Berlin, Germany.
FAU - Sittel, Christian
AU  - Sittel C
AD  - Department of Otorhinolaryngology, Klinikum Stuttgart, Katharinenhospital, 
      Stuttgart, Germany.
FAU - Gugatschka, Markus
AU  - Gugatschka M
AD  - Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria.
FAU - Arens, Christoph
AU  - Arens C
AD  - Department of Otorhinolaryngology, Otto-von-Guericke University Magdeburg, 
      Magdeburg, Germany.
FAU - Lang-Roth, Ruth
AU  - Lang-Roth R
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, 
      Cologne, Germany.
FAU - Wittekindt, Claus
AU  - Wittekindt C
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital 
      Giessen and Marburg, Giessen, Germany.
FAU - Hagen, Rudolf
AU  - Hagen R
AD  - Department of Otorhinolaryngology, University of Wuerzburg, Wuerzburg, Germany.
FAU - Muller, Andreas H
AU  - Muller AH
AD  - Department of Otorhinolaryngology, SRH Wald-Klinikum Gera, Gera, Germany.
FAU - Volk, Gerd F
AU  - Volk GF
AD  - Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
FAU - Guntinas-Lichius, Orlando
AU  - Guntinas-Lichius O
AD  - Department of Otorhinolaryngology, Jena University Hospital, Jena, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20150130
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Health Status Indicators
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Otorhinolaryngologic Surgical Procedures/*methods
MH  - Prospective Studies
MH  - Quality of Life
MH  - Treatment Outcome
MH  - Vocal Cord Paralysis/*surgery
MH  - Young Adult
OTO - NOTNLM
OT  - Bilateral vocal fold paralysis
OT  - prospective study
OT  - transoral approach
OT  - treatment outcome
EDAT- 2015/02/04 06:00
MHDA- 2015/08/05 06:00
CRDT- 2015/02/04 06:00
PHST- 2014/09/01 00:00 [received]
PHST- 2014/11/03 00:00 [revised]
PHST- 2014/12/12 00:00 [accepted]
PHST- 2015/02/04 06:00 [entrez]
PHST- 2015/02/04 06:00 [pubmed]
PHST- 2015/08/05 06:00 [medline]
AID - 10.1002/lary.25137 [doi]
PST - ppublish
SO  - Laryngoscope. 2015 Jun;125(6):1401-8. doi: 10.1002/lary.25137. Epub 2015 Jan 30.