An Ex‐vivo Model Examining Acoustics and Aerodynamic Effects Following Medialization With and Without Arytenoid Adduction

Objectives/Hypothesis Quantify differences in acoustics and intraglottal flow fields between Thyroplasty Type 1 (TT1) with and without arytenoid adduction (AA) using excised canine larynx model. Study Design Basic science experiments using excised larynges. Methods Surgical procedures were implement...

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Bibliographic Details
Published in:The Laryngoscope 2023-03, Vol.133 (3), p.621-627
Main Authors: Maddox, Alexandra, Oren, Liran, Farbos de Luzan, Charles, Howell, Rebecca, Gutmark, Ephraim, Khosla, Sid
Format: Article
Language:English
Subjects:
Acoustics
Animals
arytenoid adduction
Arytenoid Cartilage - surgery
Dogs
Glottis
intraglottal flow
Laryngoplasty
Laryngoscopy
Larynx - surgery
medialization laryngoplasty
Phonation
unilateral vocal fold paralysis
Vocal Cord Paralysis - surgery
Vocal Cords
vocal efficiency
Vortices
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Summary:Objectives/Hypothesis Quantify differences in acoustics and intraglottal flow fields between Thyroplasty Type 1 (TT1) with and without arytenoid adduction (AA) using excised canine larynx model. Study Design Basic science experiments using excised larynges. Methods Surgical procedures were implemented in eight excised canine larynges. Acoustics and intraglottal flow measurements were taken at low and high subglottal pressures in each experimental setup. Results In all larynges, vocal efficiency (VE) and cepstrum peak prominence (CPP) were higher, and the mean phonatory flow rate was lower in TT1 with AA than without AA. The glottal asymmetry is reduced with AA and promotes the formation of stronger vortices in the glottal flow during the closing phase of the vibrating folds. Conclusions Findings suggest a clear acoustic and aerodynamic benefit to the addition of AA when performing TT1. It shows significant improvement in CPP, translating to decreased breathiness and dysphonia and increased VE, leading to easier and more sustainable phonation. Stronger intraglottal vortices are known to be correlated with the loudness of voice produced by phonation. Level of Evidence N/A Laryngoscope, 133:621–627, 2023
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.30235