Temporalis fascia transplant for vocal fold scar and sulcus vocalis

• Published in: The Laryngoscope Vol. 124; no. 7; pp. 1653 - 1658
• Main Authors: Pitman, Michael J., Rubino, Shaina M., Cooper, Amy L.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01-07-2014; Wiley Subscription Services, Inc
• Subjects: Adult; autologous transplantation of temporalis fascia into the vocal fold; Cicatrix - complications; Cicatrix - pathology; Cicatrix - surgery; Dysphonia; Fascia - transplantation; Female; Follow-Up Studies; Humans; Laryngeal Muscles - transplantation; Male; Middle Aged; Phonation; Reconstructive Surgical Procedures - methods; Retrospective Studies; sulcus vocalis; Transplantation, Autologous; Transplants & implants; Treatment Outcome; Vocal Cords - physiopathology; Vocal Cords - surgery; vocal fold scar; Voice Disorders - etiology; Voice Disorders - physiopathology; Voice Disorders - surgery; Voice Quality; Dysphonia; sulcus vocalis; vocal fold scar; autologous transplantation of temporalis fascia into the vocal fold
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.24536

Objectives/Hypothesis
To evaluate vocal outcomes in 10 patients 1 year after autologous transplantation of temporalis fascia into Reinke's space (ATFV) for vocal fold scar and sulcus vocalis.
Study Design
Retrospective, clinical case series.
Methods
Subjective and objective evaluation was performed 12 months after surgery using laryngovideostroboscopy (LVS) in all patients, the Voice Handicap Index‐10 (VHI‐10) in seven patients, GRBAS (grade, roughness, breathiness, asthenia, strain) scale in nine patients, and noise‐to‐harmonics ratio (NHR), phonatory range (PR) and maximum phonation time (MPT) in six patients.
Results
LVS improved in all but one patient. A significant decrease was noted in the GRBAS subscales grade, roughness, asthenia, and strain (P < .05). Breathiness was almost significant, with a P value of .052. There was an average decrease in the VHI‐10 of 8.14 (P = .032). NHR, MPT, and PR did not statistically improve.
Conclusions
ATFV for vocal fold scar and sulcus vocalis results in significant subjective vocal improvement that persists at least 1 year after surgery.
Level of Evidence
4 Laryngoscope, 124:1653–1658, 2014