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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentation 4 - Laryngology/Broncho-Esophagology

Improved Voice After Type 1 Thyroplasty Despite Frailty

Tuesday, October 14, 2025

9:36 AM - 9:42 AM EDT

Location: 120

Disclosure(s):

Ari D. Schuman, MD, MSCR:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Julina Ongkasuwan, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Adam R. Szymanowski, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Frailty is associated with high mortality and morbidity, even with low-risk procedures. However, the role of frailty in the quality of life outcomes is not well characterized. We sought to understand the relationship between frailty and voice outcomes with type 1 thyroplasty.

Methods: Data were collected for all type 1 thyroplasties performed from 2017 until 2022. Voice was evaluated pre- and post-operatively with perceptual voice measures (GRBAS) and Voice Handicap Index-10 (VHI-10). Frailty was measured using the modified frailty index-5 (MFI-5). Data were compared using paired t-tests.

Results: 58 patients underwent surgery (26 female, 44.8%). Of these, 36 were for reduced or absent vocal fold mobility (62.1%) and 22 were for atrophy (37.9%). Mean age was 61.6 (95% confidence interval [CI] 57.2-66.1). Eighteen patients had an MFI-5 score of 0 (31%), 22 MFI-5 = 1 (37.9%), 14 MFI-5 = 2 (24.1%) and 4 MFI-5 = 3 (6.9%). Overall voice scores improved in grade (preop 2.2, 95% CI 2.0-2.4; postop 1.3, 1.1-1.6, p< 0.0001), breathiness (preop 1.5, 1.1-1.8; postop 0.5, 0.3-0.7, p< 0.0001), asthenia (preop 1.9, 1.5-2.2; postop 0.8, 0.5-1.0, p< 0.0001), and strain (preop 1.1, 0.8-1.4; postop 0.7, 0.5-0.9, p=0.0125). Roughness was stable (preop 1.1, 0.8-1.4; postop 0.9, 0.7-1.1, p=0.192). Improvements in grade, breathiness, and asthenia all held with increasing MFI-5 (MFI-5 = 1: grade p=0.0004, breathiness p=0.0029, asthenia p=0.0007; MFI-5 = 2: grade p< 0.0001, breathiness p=0.0022, asthenia p=0.0003). With only four patients with MFI-5 = 3, comparison was limited. Sixteen patients had pre- and post-op VHI-10 data. Mean preop VHI-10 was 29 (95% CI 22.5-35.5); post-op decreased to 18.4 (12.3-24.5, p=0.0045). Among the least frail patients (MFI-5 = 0), preop was 37.6 (13.5-61.7) and post-op 24.4 (4.7-44.1, p=0.2305). However, with higher frailty scores, the decrease was significant (MFI-5 = 1: preop 26, 23.3-28.7, postop 15.7, 9.5-21.9, p=0.0025). There were not adequate VHI-10 scores for higher frailty scores for analysis.

Conclusions: Improvements in voice after type 1 thyroplasty are seen despite increasing frailty scores.

Presenting Author(s)

Ari D. Schuman, MD, MSCR

Fellow
University of Cincinnati
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

AB

Alex H. Beck, BS

Baylor College of Medicine
Houston, Texas, United States

Disclosure information not submitted.
Louis G. Abarca, BA

Medical Student
Baylor College of Medicine
Houston, Texas, United States

Disclosure information not submitted.
SB

Sarah Blumhardt, CCC-SLP

Baylor College of Medicine, United States

Disclosure information not submitted.
MB

Madeline Brungardt, CCC-SLP

Baylor College of Medicine, United States

Disclosure information not submitted.
Julina Ongkasuwan, MD

Professor
Baylor Clg of Med
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

AS

Adam R. Szymanowski, MD

Assistant Professor
Baylor College of Medicine
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.