caa a22 4500 606184805 CHVBK 20210128100828.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00405-014-3418-3 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3418-3 Long-term vocal outcomes of refined nerve-muscle pedicle flap implantation combined with arytenoid adduction [Elektronische Daten] [Narihiro Kodama, Tetsuji Sanuki, Yoshihiko Kumai, Eiji Yumoto] The objective of this study is to evaluate long-term efficacy of refined nerve-muscle pedicle (NMP) flap implantation combined with arytenoid adduction (AA) for treatment of unilateral vocal fold paralysis (UVFP). The authors retrospectively reviewed 33 patients with UVFP who received refined NMP flap implantation with AA and were followed up over a 1-year period. Evaluation of vocal fold vibration (regularity, amplitude, and glottal gap), aerodynamic analysis (maximum phonation time [MPT] and mean airflow rate [MFR]), and perceptual evaluation (Grade and Breathiness) were performed preoperatively and at five different time points (1, 3, 6, 12, and 24months) postoperatively. All voice parameters improved significantly postoperatively. All parameters except MFR also continued to improve over the course of 24months. In the videostroboscopic analysis, the parameter for regularity 24months after surgery was significantly improved compared with that at 1, 3, and 6months after surgery. There were also significant improvements in amplitude and the glottal gap 24months after surgery in comparison with values at 3 and 6months after surgery and 3months after surgery, respectively. Significant improvement in aerodynamic and perceptual measurements during the follow-up period together with near-normal vocal fold vibration was achieved by delayed reinnervation with refined NMP flap implantation and AA. The combined surgical technique is effective in the treatment of severe breathy dysphonia due to UVFP. Level of evidence 4. Springer-Verlag Berlin Heidelberg, 2014 Refined nerve-muscle pedicle flap implantation nationallicence Unilateral vocal fold paralysis nationallicence Videostroboscopy nationallicence Aerodynamic analysis nationallicence Perceptual evaluation nationallicence Kodama Narihiro Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut Sanuki Tetsuji Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut Kumai Yoshihiko Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut Yumoto Eiji Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/3(2015-03-01), 681-688 0937-4477 272:3<681 2015 272 405 https://doi.org/10.1007/s00405-014-3418-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3418-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kodama Narihiro Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 700 1- Sanuki Tetsuji Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 700 1- Kumai Yoshihiko Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 700 1- Yumoto Eiji Department of Otolaryngology Head and Neck Surgery, Kumamoto University Graduate School of Medicine, Honjyo, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/3(2015-03-01), 681-688 0937-4477 272:3<681 2015 272 405