Author(s)
Katherine C. Yung, MD
Eric J.Formeister, MD, MS
Mark S. Courey, MD
Affiliation(s)
University of CA - San Francisco
Abstract:
Objective: The purpose of this study is to evaluate the safety and success rate of medialization laryngoplasty in the elderly population. Study Design: Retrospective chart review. Methods: Charts of 100 patients over 65 years of age who underwent medialization laryngoplasty between January 2008 and May 2016 were reviewed. The voice handicap index (VHI) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scores were recorded pre- and post-operatively. Complications, need for additional procedures, and pre-operative work-up details were recorded. Results: No airway obstruction or other major complications occurred. Transient vocal fold edema was noted in 24%, and minor wound complications were noted in 5%. Success rate was 79% based on improvement in GRBAS or VHI score and absence of major complications. Failure rate was 21% based on poor voice outcome with or without minor complications (8% with minor complications and 13% without complications). Five percent of patients required revision surgery due to poor voice outcome, and another 8% required injection augmentation. Seventy percent of patients with minor complications had a good voice outcome. Of patients with good voice outcome, 7.6% had incomplete glottic closure. In patients with a successful result, 35.4% received preoperative clearance, while in patients with a poor result, only 9.5% received preoperative clearance (p <0.05). Conclusion: Medialization laryngoplasty in the elderly has a complication rate comparable to that in the general population. Incomplete closure of the vocal folds is not necessarily an indicator of poor outcome. Preoperative medical clearance may improve medialization laryngoplasty outcomes in the elderly.