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Justin McNamar '07

Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy

Hypothesis: Adduction arytenopexy (AP) with thyroplasty provides improved physiological placement of the vocal fold and therefore provides improved acoustic, aerodynamic, vibratory function as compared to arytenoid adduction (AA) with thyroplasty.

Methods: Five cadaveric human larynges were prepared by removing supraglottic tissues and fixing the non-test vocal fold medially on the cricoid facet with a needle in a physiologic phonating position. Each test vocal fold was then sequentially tested using an excised larynx phonation system, first with AA with silastic medialization and then coverted to AP without changing the contralateral fold position or silastic wedge. The excised larynx setup allowed for simulataneous collection of data, specifically: subglottic pressure, phonation threshold pressure (PTP), average airflow, acoustic output, and full-frame high-speed digital imaging.

Results: Aerodynamic evaluation was similar for each group with similar subglottic pressure versus output curves. Conditions involving AP typically had PTP values that were 80% of that for comparable AA conditions. Acoustic evaluation revealed differences between the two groups. Each AA was found to be vibrating with two dominant frequencies with their associated harmonics. Each AP vibrated at a single dominant frequency with its harmonics.

Conclusion: AP provides improved vocal outcomes by decreasing system noise and decreasing PTP which may lead to a stronger glottal signal with decreased vocal effort.

McNamar, J. Montequin, D., Welham, N. Dailey, S. (2007) Aerodynamic, Acoustic, and Vibratory Comparison of Arytenoid Adduction and Adduction Arytenopexy, submitted.

 


 

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Otolaryngology Surgery University of Wisconsin Department of Surgery
First published: 07/15/02 Last updated: 11/24/09 webmaster@surgery.wisc.edu
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