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Original Investigation
June 2015

Medialization Laryngoplasty for Odynophonia

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, University of Washington School of Medicine, Seattle
  • 2Department of Otolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor
  • 3Department of Otolaryngology–Head and Neck Surgery, Weill Cornell Medical College, New York, New York
JAMA Otolaryngol Head Neck Surg. 2015;141(6):556-561. doi:10.1001/jamaoto.2015.0333

Importance  Medialization laryngoplasty (ML) remains the gold standard for the long-term treatment of hoarseness related to glottal insufficiency. Odynophonia is a less common manifestation of glottal insufficiency related to vocal fold motion impairment (VFMI), and ML is hypothesized to relieve pain associated with this condition.

Objective  To evaluate whether patients with VFMI and a chief complaint of odynophonia may achieve pain relief with ML, regardless of the degree of vocal impairment.

Design, Setting, and Participants  We conducted a retrospective review of medical records for 8 patients with VFMI and a chief complaint of odynophonia who were treated at 2 tertiary care laryngology centers over a 2-year period.

Interventions  All patients underwent ML.

Main Outcomes and Measures  Patient-reported relief of pain, preoperative and postoperative Voice Handicap Index 10 (VHI-10) scores, and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scores were obtained.

Results  All eight patients (5 women and 3 men; mean age, 42 years) had durable relief of their discomfort postoperatively (average follow-up, 14 months). Mean VHI-10 scores improved significantly from 17.9 preoperatively to 6.3 postoperatively (P = .001), while perceptual voice parameters as measured by CAPE-V were unchanged. There were no complications.

Conclusions and Relevance  In select cases of VFMI, ML can relieve pain related to voice use, even in the absence of significant hoarseness.