Very long-term Voice Handicap Index Voice Outcomes after Montgomery Thyroplasty: A cross-sectional study

Abstract

Objective: The aim of this multicentric cross-sectional study was to examine the permanency of Montgomery thyroplasty (MTIS) results from a patient's perspective.Design: The study consisted of collecting Voice Handicap Index (VHI-30) questionnaires from patients who had previously been operated with MTIS between 2 and 12years before. Very long-term (>2years) postoperative data were compared with the previously acquired preoperative and early postoperative VHI results. Influence of factors such as age, gender, size/side of the prosthesis and length of the follow-up were also analysed.Setting: Multicentric study involving three tertiary European voice centres.Participants: Forty-nine unilateral vocal fold paralysis (UVFP) patients, treated by MTIS, were included in the study.Main outcome measures: The Voice Handicap Index-30 score.Results & Conclusions: The median VHI was significantly different over time-points (Friedman's test P<.001), with a significant difference between preoperative and early postoperative time-points (median VHI: 70 vs 21, respectively; P<.001) and between preoperative and very long-term postoperative time-points (median VHI: 70 vs 16, respectively; P<.001). The median VHI did not differ for the early and very long-term postoperative time-points (median VHI: 21 vs 16; P=.470).Age differences, gender differences and size/side differences of the prostheses, centres where surgery took place and length of the follow-up showed no significant influence.Medialisation thyroplasty (MT) overall and MTIS, in particular, should be considered as a possible standard of care for UVFP when permanency of voice results is sought.