Regularity of voice recovery and arytenoid motion after closed reduction in patients with arytenoid dislocation: a self-controlled clinical study

Abstract

Background: Closed reduction is an effective treatment for arytenoid dislocation. The treatment is usually given more than once to obtain normal voice. However, when to perform the next closed reduction remains controversial.

Objective: This study aimed to observe the regularity of the voice recovery and the arytenoid motion in patients with arytenoid dislocation after closed reduction.

Material and methods: Thirty-one patients were recruited from September 2017 to April 2019. Results of their clinical data were reviewed retrospectively.

Results: Among the thirty-one patients, their VHI scores, F0, jitter%, shimmer%, glottal-to-noise excitation %(GNE), maximum phonation time (MPT) and GRBAS Scale (G, R, B, A) improved significantly (p < .05), but there was no statistically significant difference for GRBAS Scale (S) (p>.05). The duration between last closed reduction and the restoring normal voice ranged from 1–8 days, with a mean of 4.65 ± 0.57 days, at the same time the glottis was completely closed.

Conclusions and significance: Closed reduction for patients with arytenoid dislocation is an effective procedure. A time window between 4.08th and 5.22th day (at a confidence level of 95%) after the last closed reduction was identified to be critical for voice recovery.

Chinese abstract

背景：闭合复位是治疗杓状关节脱位的有效方法。治疗通常需要一次以上才能获得正常的声音。不过, 何时进行下一次闭合复位治疗仍存在争议。

目的：观察闭合复位后杓状关节脱位患者语音恢复及杓状关节活动的规律。

材料与方法：共招募自2017年9月至2019年4月的31名患者。回顾性分析其临床资料。

结果：三十一例患者中, VHI评分、F0、抖动百分率、闪动百分率、声门噪声激发率（GNE）、最大发声时间（MPT）、GRBAS量表（G、R、B、A）均有显著改善（P ＜0.05）, 但GRBAS量表（S）差异无统计学意义（P>0.05）。最后一次闭合复位至恢复正常嗓音的时间为1～8天, 平均4.65±0.57天, 同时声门完全闭合。

结论及意义：闭合复位是治疗杓状关节脱位的有效方法。最后一次闭合复位后第4.08天到第5.22天之间的时间窗（置信水平95%）被确定为语音恢复的关键。

Keywords:

• Arytenoid dislocation
• closed reduction
• vocal fold motion
• voice recovery time
• cricoarytenoid joint three-dimensional reconstruction

Acknowledgments

The authors thank Prof. Shu Wang (National University of Singapore) for helpful discussion and review of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Project supported by the Natural Science Foundation of Zhejiang province, China (Grant No. LGF18H160009 and No. LY17H130001). They provided financial assistance in the collection, writing of the report, and decision to submit the article for publication.