PMC9444610_01
The endoscopy executed during sleep evidences the paradoxical movement of adduction during inspiration.
gr1.jpg
PMC9444610_01_gr1.jpg
fig0005
The endoscopy revealed a paradoxical movement of adduction during inspiration (Fig. 1) with a marked inspiratory stridor, while expiratory abduction movement of the vocal folds was conserved.
Multidimensional voice program (MDVP) underlines preoperatory perturbations in frequency and amplitude.
gr2.jpg
PMC9444610_01_gr2.jpg
fig0010
Shim - 6.246; vAm - 17.635) with a mild alteration of noise to harmonic ratio (NHR = 0.156) (Fig. 2). Maximum phonatory time (MPT) was 11 seconds. Self-evaluation of voice with voice handicap index (VHI) was submitted to patient in order to measure physical, emotional and functional complaints of dysphonia; preoperatory score was of 5 (mild alteration).
The control endoscopy executed at two months from surgery shows the good increase of the glottic respiratory space.
gr3.jpg
PMC9444610_01_gr3.jpg
fig0015
The two-months control endoscopy (Fig. 3) evidenced a good increase of the glottic respiratory space.
The spectrographic examination executed after surgery points out the presence of noise between the harmonics and of diplophony.
gr4.jpg
PMC9444610_01_gr4.jpg
fig0020
Post-surgical perceptual evaluation of voice remained good (G1R0B2A0S0 - mild alteration), the spectrographic examination (Fig. 4) showed a mild worsening of NHR and a dyplophonia.
The multidimensional voice program evidences the postoperatory mild worsening of the perturbations in frequency and amplitude.
gr5.jpg
PMC9444610_01_gr5.jpg
fig0025
MDVP evaluation, all the above mentioned values were slightly worsened (Fig. 5), but no modification of voice quality was perceived by the patient and his post-surgical VHI had a score of 8 (mild alteration). MPT remained unchanged (11 seconds).