Abstract：
Glottic insufficiency is incomplete or soft closure of the true vocal folds during phonation and is a common cause of dysphonia. Treatment includes voice therapy, type I thyroplasty, vocal fold injection augmentation (with materials such as autologous fat), arytenoid cartilage repositioning, or a combination of treatment modalities. The present study aimed to compare long-term outcomes of lipoinjection medialization with type I thyroplasty for patients with glottic insufficiency.
METHODS: Adult voice center patients who had undergone surgical vocal fold medialization with autologous lipoinjection or with type I thyroplasty for glottic insufficiency were included in this retrospective study. The primary outcome measures were the need for further medialization surgery and improvement in the glottic gap.
RESULTS: There were 172 subjects included in this study: 100 subjects underwent type I thyroplasty and 72 subjects underwent autologous lipoinjection medialization. Neither age nor gender differed significantly between thyroplasty and lipoinjection groups. The rate of further medialization surgery did not differ significantly between thyroplasty and lipoinjection groups, but further medialization surgery was performed longer after the initial operation in the thyroplasty group Baseline glottic gap did not differ significantly between thyroplasty and lipoinjection groups. When improvement from baseline was compared between thyroplasty and lipoinjection subjects, the improvement from baseline was similar for both groups at 6 months and at 12 months. Voice handicap index scores improved significantly after thyroplasty or after lipoinjection, and the improvement from baseline was similar in both cohorts.
CONCLUSIONS: Both autologous lipoinjection medialization and type I thyroplasty provide effective medialization for patients with glottic insufficiency. Both techniques yield similar reoperation rates, and the benefit of surgery appears to last for at least 1 year for most patients.
METHODS: Adult voice center patients who had undergone surgical vocal fold medialization with autologous lipoinjection or with type I thyroplasty for glottic insufficiency were included in this retrospective study. The primary outcome measures were the need for further medialization surgery and improvement in the glottic gap.
RESULTS: There were 172 subjects included in this study: 100 subjects underwent type I thyroplasty and 72 subjects underwent autologous lipoinjection medialization. Neither age nor gender differed significantly between thyroplasty and lipoinjection groups. The rate of further medialization surgery did not differ significantly between thyroplasty and lipoinjection groups, but further medialization surgery was performed longer after the initial operation in the thyroplasty group Baseline glottic gap did not differ significantly between thyroplasty and lipoinjection groups. When improvement from baseline was compared between thyroplasty and lipoinjection subjects, the improvement from baseline was similar for both groups at 6 months and at 12 months. Voice handicap index scores improved significantly after thyroplasty or after lipoinjection, and the improvement from baseline was similar in both cohorts.
CONCLUSIONS: Both autologous lipoinjection medialization and type I thyroplasty provide effective medialization for patients with glottic insufficiency. Both techniques yield similar reoperation rates, and the benefit of surgery appears to last for at least 1 year for most patients.
摘要：
声门功能不全是发声过程中真实声带的不完全或软闭合，是发声障碍的常见原因。治疗包括语音治疗，Ⅰ型甲状腺成形术,声带注射增强（使用自体脂肪等材料），软骨重新定位，或治疗方式的组合。本研究旨在比较声门功能不全患者的点注射中介化与I型甲状腺成形术的长期结果。
方法：这项回顾性研究包括成人语音中心患者，这些患者在声门功能不全的情况下接受了自体肌投射或I型甲状腺成形术的手术声带介导。主要结果指标是需要进一步的中介化手术和声门间隙的改善。
结果：本研究包括172名受试者：100名受试者接受了I型甲状腺成形术，72名受试者接受了自体点注射介导。甲状腺成形术和点注射组之间的年龄和性别均无明显差异。甲状腺成形术和点注射组之间的进一步的中介化手术率没有显着差异，但在甲状腺成形术组患者中,基线声门间隙在甲状腺成形术组与下注射组之间没有显著差异。当比较甲状腺成形术和点注射受试者的基线改善时，两组在6个月和12个月时相对于基线的改善相似.在甲状腺成形术后或点射后，嗓音障碍指数得分显着提高，并且两个队列中相对于基线的改善相似.
结论：自体点注射和I型甲状腺成形术都为声门功能不全患者提供了有效的介导。两种技术产生相似的再操作率，对于大多数患者来说，手术的益处似乎持续至少1年。
方法：这项回顾性研究包括成人语音中心患者，这些患者在声门功能不全的情况下接受了自体肌投射或I型甲状腺成形术的手术声带介导。主要结果指标是需要进一步的中介化手术和声门间隙的改善。
结果：本研究包括172名受试者：100名受试者接受了I型甲状腺成形术，72名受试者接受了自体点注射介导。甲状腺成形术和点注射组之间的年龄和性别均无明显差异。甲状腺成形术和点注射组之间的进一步的中介化手术率没有显着差异，但在甲状腺成形术组患者中,基线声门间隙在甲状腺成形术组与下注射组之间没有显著差异。当比较甲状腺成形术和点注射受试者的基线改善时，两组在6个月和12个月时相对于基线的改善相似.在甲状腺成形术后或点射后，嗓音障碍指数得分显着提高，并且两个队列中相对于基线的改善相似.
结论：自体点注射和I型甲状腺成形术都为声门功能不全患者提供了有效的介导。两种技术产生相似的再操作率，对于大多数患者来说，手术的益处似乎持续至少1年。
