Breathiness and Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) in Patients Undergoing Medialization Laryngoplasty With or Without Arytenoid Adduction

ABSTRACT Objectives We hypothesized that, in patients with unilateral vocal foldparalysis (UVFP), the auditory-perception of breathiness measured with Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) would be higher preoperatively in patients who undergo medialization laryngoplasty(ML) with arytenoid adduction(AA) compared to ML alone. We further hypothesized that increased breathiness would correlate with increased glottalarea at maximum glottalclosure. Study Design Retrospective chart review. Methods CAPE-V recordings were rated by expert judges in 105 subjects with UVFP (47 ML+AA and 58 ML). Component scores of the CAPE-V prior to laryngeal framework surgery and those at 3 and/or 12 months postoperatively were compared. Assessment of glottalarea width during maximum glottalclosure was attempted. Results Breathiness scores prior to laryngeal framework surgery were significantly greater in UVFP patients having ML+AA compared to ML only (P Conclusions In patients with UVFP baseline perception of breathiness is greater in those clinically selected for ML+AA compared to ML only. Glottalarea measurements were not representative of the UVFP cohort and more stringent criteria are needed for valid and reliable glottalarea assessment when using clinical flexible stroboscopicexams. Findings support the idea that surgeons may be making decisions about AA based, to at least some degree, on auditory perceptual evaluation of voice.