Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P213

Poster Presentations

Effect of Sinus Surgery on the Voice
Michela Borrelli (Presenter); Anca M. Barbu, MD;
Arash Shamsian; Masa Petrovic; Martin L. Hopp, MD, PhD
Objectives: Chronic sinusitis (CS) has been suspected to be
a risk factor for voice disorders, although studies confirming
the effect of functional endoscopic sinus surgery (FESS), a
treatment for CS, on patients with vocal dysfunction are
sparse. We sought to determine the effect of FESS on vocal
dysfunction.
Methods: Using the Voice-Related Quality of Life (V-RQOL),
a 10-item validated quality-of-life instrument, we studied
patients with moderate to severe CS, as measured by the
22-item Sino-Nasal Outcome Test (SNOT-22), to identify the
effect of FESS on vocal dysfunction. Lower scores on the
V-RQOL denote worse function. The V-RQOL was distributed
preoperatively and 3 months postoperatively. Student t test was
used to compare presurgery and postsurgery scores.
Results: A total of 182 continuous CS patients were asked to
complete the V-RQOL, of which 156 patients (75 female and
81 male) completed the V-RQOL form preoperatively. Prior to
surgery, the mean calculated V-RQOL score + SD was 93.04 +
12.93. Of the 156 patients who completed the V-RQOL preoperatively, 40 patients completed the V-RQOL at the 3-month
follow-up. The mean 3-month V-RQOL score + SD was 94.69
+ 12.27. A t test comparing preoperative V-RQOL scores with
3-month follow-up scores gave P = .0203. A t test comparing
preoperative abnormal voice scores (<91.25) with their
respective 3-month follow-up scores (n = 8) gave P = .0165.
Conclusions: This study shows that voice-related quality of
life is positively affected by undergoing sinus surgery because
patients with CS suffer from diminished voice-related quality
of life. Comparing preoperative V-RQOL scores with 3-month
follow-up scores shows that there is a significant difference in
vocal quality of life following FESS for both the patients scoring abnormally on the V-RQOL and the entire cohort.
Effects of Vocal Fold Paresis on Acoustics
and Aerodynamics of Voice
Pranati Pillutla (Presenter); Zhaoyan Zhang, PhD;
Dinesh K. Chhetri, MD
Objectives: Although vocal fold (VF) paresis and vibratory
asymmetry may be present with perceptually normal voice,
the degree of paresis that causes perceptual changes in voice
remains unclear. The aim of this study was to elucidate effects
of laryngeal asymmetry on voice quality.
Methods: An in vivo canine phonation model was used to
model unilateral VF paresis. Ipsilateral recurrent laryngeal

nerve (RLN) was stimulated over 11 graded levels, from
threshold to maximal muscle activation, whereas contralateral
RLN was stimulated at 3 constant levels (80%, 90%, and
100%). Bilateral superior laryngeal nerves (SLNs) were stimulated at 3 levels (0%, 50%, and 100%). Phonation was performed at 3 airflow levels. Cepstral peak prominence (CPP)
was calculated, and subglottal pressure was measured over
281 unique phonatory conditions.
Results: Subglottal pressure increased across increasing
RLN and SLN activation conditions, confirming graded activation. As ipsilateral RLN stimulation increased from zero to
maximal, CPP improved and perceptual quality of the acoustic
signal improved. At low levels of contralateral RLN stimulation (80%), increasing ipsilateral RLN stimulation continued
to increase CPP, whereas at higher contralateral RLN stimulation (90% or 100%), ipsilateral RLN stimulation past 60% did
not increase CPP further. Maximal CPP occurred at levels of
50% bilateral CT activation.
Conclusions: Acoustic quality improves as paresis improves
toward normal VF function. Strong contralateral laryngeal
function can compensate for ipsilateral dense paresis, where
CPPs were similar at greater than 60% ipsilateral muscle activation. When weaker contralateral activation is present, voice
quality improvement requires further improvement in function on the paretic side.
Epidemiology and Outcomes in Laryngeal
Trauma: A Trauma Quality Improvement
Program Study
Parsa P. Salehi, MD (Presenter); Alexandra Bourdillon;
Benjamin Steren; Sina J. Torabi; Kevin Pei, MD;
Babak Azizzadeh; Yan H. Lee, MD
Objectives: Laryngeal trauma is poorly studied and is
associated with serious morbidity and mortality in patients.
This study uses a large database to understand the epidemi-
ological data regarding the natural history of laryngeal
trauma.
Methods: Data from the American College of Surgeons
Trauma Quality Improvement Program (ACS TQIP) participant user data file were retrospectively queried from the years
2014 through 2016. Clinical encounters that involved a repair
of a laryngeal fracture were isolated using the International
Classification of Diseases, Ninth Revision, Clinical Modification
code 31.64. Diagnostic parameters including cause of injury, site
of injury, recorded diagnoses, other procedures, and average
length of stay were analyzed.
Results: From 2014 to 2016 there were 93 reported cases of
laryngeal fracture requiring repair. Three cases met the exclusion criteria because of inconsistent coding. Among head and
neck injuries, the most common diagnosis types included fractures (90%, 81/90) and open wounds (61.11%, 55/90); 26.67%
of cases (24/90) were complicated by traumatic brain injury
and 38.39% of cases (35/90) were complicated by injuries to
the face. Assault accounted for 36.67% of injuries (33/90);
within assaults, the most common causes were assault by

Laryngology

Conclusions: There are no data to guide dosing and tapering
of oral corticosteroids for the short courses indicated in acute
laryngeal pathology. However, principles of corticosteroid
and cellular physiology, elucidated for longer-term dosing in
rheumatologic conditions, can inform dosage and taper regimens to treat acute laryngeal pathology.

P213

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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