Optimal arytenoid adduction based on quantitative real-time voice aanalysis

Abstract

Hypothesis: The optimal degree of arytenoid rotation for arytenoid adduction (AA) can be determined using quantitative real-time voice analysis. Study Design: Repeated measures with each larynx serving as its own control. Methods: Unilateral vocal fold paralysis (VFP) was modeled in five excised canine larynges. Medialization laryngoplasty (ML) was performed, followed by AA. The optimal degree of arytenoid rotation was determined using real-time measurements of vocal efficiency (VE), percent jitter, and percent shimmer. After the optimal degree of rotation was determined, the arytenoid was hypo- and hyperrotated 10% ± 2% of the optimal angle to mimic hypoadducted and hyperadducted states. Aerodynamic, acoustic, and mucosal wave measurements were recorded. Results: Mean optimal angle of arytenoid adduction was 151.4 ± 2.5°. VE differed significantly across experimental conditions (P =.003). Optimal AA produced the highest VE of any treatment, but this value did not reach that produced in the normal condition. Percent jitter (P