Voice outcome indicators for unilateral vocal fold paralysis surgery: A survey among surgeons

Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Oct;136(5):343-347. doi: 10.1016/j.anorl.2018.07.009. Epub 2019 Apr 19.


Introduction: Standardization of voice outcomes indicators (VOIs) is an important issue when it comes to evaluating and comparing surgical treatments for Unilateral Vocal Fold Paralysis (UVFP). In a recent review, 11 VOIs were found to represent 80% of the VOIs cited in the literature. A survey was launched among the European laryngologists to acquire surgeons' opinions on the above mentioned preselected VOIs.

Material and method: The electronic survey took place between November and December 2016. Three general questions were asked about surgeon's practice setting(s) and experience. The eleven next questions concerned (a) surgeon's VOIs preference and (b) their estimates of post-operative target values, they would consider being satisfactory.

Results: The response rate was 16% (50 surveys). The majority of responders worked in tertiary hospitals (50%), had 15 years of experience with UVFP and performed on average 20 UVFP related procedures a year. The VOIs that were favored by the responding surgeons were, in decreasing order of importance, Voice handicap Index (VHI-30), Maximum Phonation Time (MPT), GRBAS-I, Mean Airflow Rate (MeAF), Jitter and Shimmer. There was an excellent consensus on post-operative VOI target values between survey's results and the literature data, except for three VOIs that showed somewhat divergent tendencies (absolute VHI-30, Jitter and Shimmer).

Conclusions: Three VOIs are favored by surgeons: VHI-30, MPT and GRBAS-I. Jitter and Shimmer, although very frequently reported and statistically valid in the literature, come last concerning surgeon's choice as VOI for UVFP treatment assessment.

Keywords: Chirurgie; Enquête; Outcome; Paralysie glottique; Paralysie vocale unilatérale; Résultat; Surgery; Survey; Unilateral vocal fold palsy (UVFP); Vocal fold palsy.

MeSH terms

  • Europe
  • Humans
  • Otolaryngologists
  • Patient Outcome Assessment*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Surgeons
  • Surveys and Questionnaires
  • Vocal Cord Paralysis / surgery*