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Master Thesis

La thyroplastie de type I selon Montgomery : morbidité et évaluation vocale longitudinale

Abstract : Objectives : Thyroplasty type I with Montgomery implant is indicated for the patients suffering of unilateral vocal fold paralysis. The best criteria to choose the size of implant during the procedure is still unknown. The primary purpose of our study was to record vocal parameters before and after the surgery and to : i) analyse their assessment, ii) find a predictive factor of a long term good result. The secondary purpose was to analyse the morbidity and the long term satisfaction of patients. Material and methods : Vocal subjective parameters (VHI, G and B from GRBAS scale) and vocal objective parameters (jitter, shimmer, fuite glottique, TMP) were prospectively recorded before the surgery, during the surgery, at day 1, 1 month and 6 months later. A decrease of 18 points or less of the VHI was considered as a good result. We analysed vocal longitudinal datas and we looked for parameters connected with a long term good result. Morbidity and patient satisfaction were retrospectively analysed. Results : All the parameters improved significantly at the time of the procedure. No preoperative or intraoperative factor demonstrated a significant connection with a long term good result. The higher the increase of the maximum phonation time (MPT) was during the surgery, the best the long term result was (trend). The overall rate of adverse events was 22,2%. Patients contentment was high with 93% of people ready to have a new surgery a posteriori. Conclusion : Our results demonstrated for the first time the very early improvement of the vocal parameters. Intraoperative results were representative of the long term results. A higher increase of the MPT was noted for patients with « good results ». MPT could be the most relevant parameter to choose the right size of implant during the procedure. This result has to be confirmed on a larger sample.
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Master Thesis
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Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, June 23, 2015 - 11:27:20 AM
Last modification on : Wednesday, August 23, 2017 - 4:33:29 PM
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  • HAL Id : dumas-01166809, version 1



Isabelle Larget. La thyroplastie de type I selon Montgomery : morbidité et évaluation vocale longitudinale. Médecine humaine et pathologie. 2015. ⟨dumas-01166809⟩



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