Journal of voice : official journal of the Voice Foundation · 2025
Changes in Adductory Laryngeal Diadochokinetic Interpretation in Patients Before and After Medialization Procedures for Vocal Fold Paresis/Paralysis.
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Thompson Chandler C, Menton Stacey M, Candelo Estephania, Weiss Natalie, Rutt Amy L
Аннотация
OBJECTIVE: Evaluation of adductory laryngeal diadochokinetic (L-DDK) interpretations in patients with vocal fold paresis/paralysis before and after injection medialization procedures.
STUDY DESIGN: Prospective cohort study METHODS: A total of 48 patients were identified and included in this study between January, 2021, and May, 2023. Written consent was obtained from each patient to utilize their clinical data for the purpose of this investigation. Of the 48 patients, 20 individuals completed both preoperative and postoperative assessments as per the study protocol. Data collection utilized Pentax CSL software for accurate measurements. L-DDK rate, devoicing extent, strength, and consistency were evaluated by one of two qualified speech pathologists during the initial preoperative evaluation and again during the 4-6-week postoperative evaluation. The normality of the data distribution was assessed using the Shapiro-Wilk test. Since the L-DDK rate demonstrated a normal distribution, a paired t test was employed to evaluate the differences in L-DDK rate before and after medialization procedures. Additionally, the L-DDK devoicing, strength, and consistency variables did not exhibit a normal distribution, necessitating the use of the non-parametric marginal homogeneity (Stuart-Maxwell) test to assess the changes in these parameters before and after the intervention.
RESULTS: A significant increase in L-DDK rate following the medialization procedure, with values rising from 3.4 (±0.19) preoperatively to 4.18 (±0.19) postoperatively (P < 0.001). Furthermore, a noteworthy improvement was observed in L-DDK strength, with 70% (14 out of 20) of the participants demonstrating improvement (P value: 0.0208) and a significant enhancement in L-DDK consistency, with 55% (11 out of 20) of the participants exhibiting improvement (P value:0.033). However, no significant improvement was observed in L-DDK devoicing. No differences were detected based on injectate type (hyaluronic acid-based or lipoinjection).
CONCLUSION: The assessment of L-DDK rate, strength, and consistency hold significant clinical value as it offers valuable insights into the neuromotor function of the larynx following medialization procedures for vocal fold paresis/paralysis. Our study contributes essential data on L-DDK tasks both premedialization and postmedialization, presenting a potential marker for postoperative follow-up in laryngeal procedures. However, normalizing these assessments across different age groups and sexes is crucial. Such investigation would provide a more comprehensive understanding of the applicability and reliability in clinical practice.
LAY SUMMARY: L-DDK rate, strength, and consistency are easy to administer and provide a wealth of information for the informed clinician regarding laryngeal function.
STUDY DESIGN: Prospective cohort study METHODS: A total of 48 patients were identified and included in this study between January, 2021, and May, 2023. Written consent was obtained from each patient to utilize their clinical data for the purpose of this investigation. Of the 48 patients, 20 individuals completed both preoperative and postoperative assessments as per the study protocol. Data collection utilized Pentax CSL software for accurate measurements. L-DDK rate, devoicing extent, strength, and consistency were evaluated by one of two qualified speech pathologists during the initial preoperative evaluation and again during the 4-6-week postoperative evaluation. The normality of the data distribution was assessed using the Shapiro-Wilk test. Since the L-DDK rate demonstrated a normal distribution, a paired t test was employed to evaluate the differences in L-DDK rate before and after medialization procedures. Additionally, the L-DDK devoicing, strength, and consistency variables did not exhibit a normal distribution, necessitating the use of the non-parametric marginal homogeneity (Stuart-Maxwell) test to assess the changes in these parameters before and after the intervention.
RESULTS: A significant increase in L-DDK rate following the medialization procedure, with values rising from 3.4 (±0.19) preoperatively to 4.18 (±0.19) postoperatively (P < 0.001). Furthermore, a noteworthy improvement was observed in L-DDK strength, with 70% (14 out of 20) of the participants demonstrating improvement (P value: 0.0208) and a significant enhancement in L-DDK consistency, with 55% (11 out of 20) of the participants exhibiting improvement (P value:0.033). However, no significant improvement was observed in L-DDK devoicing. No differences were detected based on injectate type (hyaluronic acid-based or lipoinjection).
CONCLUSION: The assessment of L-DDK rate, strength, and consistency hold significant clinical value as it offers valuable insights into the neuromotor function of the larynx following medialization procedures for vocal fold paresis/paralysis. Our study contributes essential data on L-DDK tasks both premedialization and postmedialization, presenting a potential marker for postoperative follow-up in laryngeal procedures. However, normalizing these assessments across different age groups and sexes is crucial. Such investigation would provide a more comprehensive understanding of the applicability and reliability in clinical practice.
LAY SUMMARY: L-DDK rate, strength, and consistency are easy to administer and provide a wealth of information for the informed clinician regarding laryngeal function.