Abstract：
OBJECTIVE: Head and neck radiation therapy (HNRT) has traditionally been considered a contraindication to vocal fold medialization procedures. Although safety has been demonstrated, we hypothesize that actual management varies. This study evaluates practice patterns of otolaryngologists regarding vocal fold medialization in patients after HNRT.
METHODS: A 25-question survey evaluating respondents\' management of patients status post HNRT with vocal fold paresis/paralysis was distributed to 357 otolaryngologists. Practice patterns regarding injection laryngoplasty (IL), medialization thyroplasty (MT), and arytenoid adduction (AA) were queried.
RESULTS: Eight-two clinicians (23%) completed the survey. Ninety-one percent of respondents were laryngologists, 9% head and neck surgeons, 3% comprehensive otolaryngologists, and 3% \"other.\" Eleven (15%) had been in practice <5 years, 19 (25%) for 5-10 years, and 46 (61%) for >10 years. No respondents considered HNRT a contraindication to IL, and 11 (14%) reported complications from the procedure. Hyaluronic acid (58, 75%) was most commonly injected. Twenty percent considered HNRT a contraindication to MT, and 37% considered it a contraindication to AA. Gore-Tex was used most commonly (65%). Twenty-seven percent reported major complications after MT. All complications occurred in the >10-year practice group, and this group was more likely to delay surgery after HNRT (p = 0.022). Respondents with complications were more likely to perform MT in HNRT patients (p = 0.0191).
CONCLUSIONS: Otolaryngologists generally do not consider HNRT to be a contraindication to IL, but some consider it a contraindication to MT/AA. Previous complications do not appear to deter surgeons from performing MT.
METHODS: N/A (Survey Study) Laryngoscope, 2024.
METHODS: A 25-question survey evaluating respondents\' management of patients status post HNRT with vocal fold paresis/paralysis was distributed to 357 otolaryngologists. Practice patterns regarding injection laryngoplasty (IL), medialization thyroplasty (MT), and arytenoid adduction (AA) were queried.
RESULTS: Eight-two clinicians (23%) completed the survey. Ninety-one percent of respondents were laryngologists, 9% head and neck surgeons, 3% comprehensive otolaryngologists, and 3% \"other.\" Eleven (15%) had been in practice <5 years, 19 (25%) for 5-10 years, and 46 (61%) for >10 years. No respondents considered HNRT a contraindication to IL, and 11 (14%) reported complications from the procedure. Hyaluronic acid (58, 75%) was most commonly injected. Twenty percent considered HNRT a contraindication to MT, and 37% considered it a contraindication to AA. Gore-Tex was used most commonly (65%). Twenty-seven percent reported major complications after MT. All complications occurred in the >10-year practice group, and this group was more likely to delay surgery after HNRT (p = 0.022). Respondents with complications were more likely to perform MT in HNRT patients (p = 0.0191).
CONCLUSIONS: Otolaryngologists generally do not consider HNRT to be a contraindication to IL, but some consider it a contraindication to MT/AA. Previous complications do not appear to deter surgeons from performing MT.
METHODS: N/A (Survey Study) Laryngoscope, 2024.
摘要：
目的：头颈部放射疗法（HNRT）传统上被认为是声带中介化手术的禁忌症。虽然已经证明了安全性，我们假设实际管理各不相同。这项研究评估了耳鼻喉科医师对HNRT后患者声带内在化的实践模式。
方法：对357名耳鼻喉科医师进行了一项25个问题的调查，评估了受访者对HNRT伴声带麻痹/麻痹患者状态的管理。关于注射喉成形术（IL）的实践模式，中介化甲状腺成形术（MT），并对Arytenoid内收（AA）进行了查询。
结果：八位临床医生（23%）完成了调查。91%的受访者是喉科医生，9％的头颈部外科医生，3％的综合耳鼻喉科医师，和3%“其他。“11人(15%)已经实践了<5年，19（25%）持续5-10年，和46（61%）超过10年。没有受访者认为HNRT是IL的禁忌症，11例(14%)报告手术并发症.透明质酸（58，75％）是最常见的注射。20%的人认为HNRT是MT的禁忌症，37%的人认为这是AA的禁忌症。最常用的是Gore-Tex（65％）。27％的人报告了MT后的主要并发症。所有并发症均发生在>10年实践组中，且本组患者在HNRT后延迟手术的可能性更大(p=0.022)。有并发症的受访者更有可能在HNRT患者中进行MT（p=0.0191）。
结论：耳鼻喉科医师通常不认为HNRT是IL的禁忌症，但有些人认为这是MT/AA的禁忌症。先前的并发症似乎并未阻止外科医生进行MT。
方法：N/A（调查研究）喉镜，2024.
方法：对357名耳鼻喉科医师进行了一项25个问题的调查，评估了受访者对HNRT伴声带麻痹/麻痹患者状态的管理。关于注射喉成形术（IL）的实践模式，中介化甲状腺成形术（MT），并对Arytenoid内收（AA）进行了查询。
结果：八位临床医生（23%）完成了调查。91%的受访者是喉科医生，9％的头颈部外科医生，3％的综合耳鼻喉科医师，和3%“其他。“11人(15%)已经实践了<5年，19（25%）持续5-10年，和46（61%）超过10年。没有受访者认为HNRT是IL的禁忌症，11例(14%)报告手术并发症.透明质酸（58，75％）是最常见的注射。20%的人认为HNRT是MT的禁忌症，37%的人认为这是AA的禁忌症。最常用的是Gore-Tex（65％）。27％的人报告了MT后的主要并发症。所有并发症均发生在>10年实践组中，且本组患者在HNRT后延迟手术的可能性更大(p=0.022)。有并发症的受访者更有可能在HNRT患者中进行MT（p=0.0191）。
结论：耳鼻喉科医师通常不认为HNRT是IL的禁忌症，但有些人认为这是MT/AA的禁忌症。先前的并发症似乎并未阻止外科医生进行MT。
方法：N/A（调查研究）喉镜，2024.
