{
  "abstract": "Importance: Thyroplasty type I is considered standard therapy in patients with chronic unilateral vocal fold paralysis (UVFP); revisions are frequently required. Objective: The aim of the study was whether synkinesis affects thyroplasty type I. Design: Retrospective data analysis. Participants: Patients with UVFP (age ≥18 years) after thyroplasty type I. Intervention of exposures: Between November 2019 and November 2022, 28 patients with chronic UVFP underwent thyroplasty type I and were followed up 6 months postoperatively. Prior to surgery, all patients underwent laryngeal electromyography (LEMG). Main outcome measures: Dysphonia Severity Index (DSI), perceptual voice sound analysis (GRBAS), voice acoustics (jitter %), maximum phonation time (MPT), voice range profile measurements (VRP), Voice Handicap Index (VHI-9), and laryngo(strobo)scopic findings were assessed preoperatively and up to 6 months after thyroplasty. For study purposes, the presence of synkinesis was retrospectively evaluated and classified according to the Crumley classification based on preoperative data. Statistical analyses were exploratory. A linear mixed-effects model was used to asses preoperative and postoperative DSI in patients with and without synkinesis. Statistical analyses were carried out with SPSS version 27. Results: Sixteen patients had a UVFP without and 12 with synkinesis. Among patients with synkinesis, 25% were classified as Crumley type II, 50% as type IV, and 25% as undefined. DSI improved significantly postoperatively across all patients ( P = .006). The greatest improvement in GRBAS score, MPT, and Jitter (%) were observed in UVFP patients with type IV and those without synkinesis. VHI-9 scores improved in patients with type IV synkinesis (n = 6) and those without synkinesis (n = 16). Complete glottal closure was achieved in most patients with (n = 7) and without synkinesis (n = 12). Conclusion: This study emphasizes the importance of preoperative LEMG in chronic UVFP before thyroplasty type I to identify unfavorable synkinesis types, as routine laryngo(strobe)scopy and voice acoustic evaluation do not allow any conclusion on aberrant reinnervation processes. Relevance: Patients with type IV are suitable candidates for thyroplasty type I. In type II and undefined synkinesis, thyroplasty type I alone is insufficient, and additional therapies should be considered.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Otorhinolaryngology, Medical University of Vienna, Austria"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Annabella Kurz MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Guan-Yuh Ho MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthias Leonhard MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Roland Paulus MD"
    },
    {
      "affs": [
        0
      ],
      "name": "Berit Schneider-Stickler MD"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cb196ftrqtcj9.bib",
  "cited_by": 0,
  "doi": "10.1177/19160216261487371",
  "fulltext_url": "https://doi.org/10.1177/19160216261487371",
  "id": "cb196ftrqtcj9",
  "issns": [
    "1916-0216"
  ],
  "landing_url": "https://doi.org/10.1177/19160216261487371",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RD1-811"
    ],
    [
      "openalex",
      "2737|Voice and Speech Disorders"
    ]
  ],
  "openalex": "W7223462786",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-24",
  "publisher": "SAGE Publishing",
  "ris": "https://research.draconitic.com/paper/cb196ftrqtcj9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:44:42Z",
      "native_id": "21e4155599a848d5b2aea6b06c621128",
      "source": "doaj",
      "url": "https://doi.org/10.1177/19160216261487371"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Voice and Speech Disorders",
      "subfield": "physiology"
    }
  ],
  "title": "Better Outcome After Thyroplasty Type I in Unilateral Vocal Fold Paralysis Without Synkinesis and Synkinetically-Reinnervated Type IV Vocal Fold Paralysis",
  "title_text": "Better Outcome After Thyroplasty Type I in Unilateral Vocal Fold Paralysis Without Synkinesis and Synkinetically-Reinnervated Type IV Vocal Fold Paralysis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:44:42Z",
  "url": "https://research.draconitic.com/paper/cb196ftrqtcj9",
  "venue": "Journal of Otolaryngology - Head and Neck Surgery",
  "versions": []
}