{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T01:19:31Z","timestamp":1767143971854,"version":"3.48.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["World j. otorhinolaryngol.-head neck surg."],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To explore the clinical efficacy of unilateral modified arytenoidectomy (UMA) in the treatment of bilateral vocal fold paralysis(BVFP) based on animal models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The UMA which had been tested in excised canine larynges with simulated BVFP was adapted into a clinical technique. The characteristics of this surgical technique involve contouring of the arytenoid cartilage. The procedure expands the vocal fold respiratory region and subglottic space of the arytenoid cartilage while preserving the muscular process to maintain partial vocal fold muscle function. A retrospective analysis was conducted on 19 patients diagnosed with BVFP who were admitted to the Department of Voice Medicine, Zhongshan Hospital of Xiamen University between April 2019 and November 2023. These patients underwent CO\n                      <jats:sub>2<\/jats:sub>\n                      laser arytenoid cartilage partial resection using a modified surgical technique. Dyspnea scores, voice handicap index scale (VHI\u201010), and subjective and objective acoustic analysis were collected pre\u2010op and post\u2010op assessments to evaluate the clinical efficacy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data analysis of patients at 6 months post\u2010op showed VHI\u201010: pre\u2010op (21.68\u2009\u00b1\u200912.40) score, post\u2010op (16.21\u2009\u00b1\u20097.68) score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.033); mMRC Dyspnea Scale: pre\u2010op (2.79\u2009\u00b1\u20090.71) score, post\u2010op (0.58\u2009\u00b1\u20090.69) score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); fundamental frequency (\n                      <jats:italic>F<\/jats:italic>\n                      0): pre\u2010op (175.54\u2009\u00b1\u200950.72) Hz, post\u2010op (190.36\u2009\u00b1\u200939.28)\u2009Hz (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.196); maximum vocalization time (MPT): pre\u2010op (4.69\u2009\u00b1\u20094.30)\u2009s, post\u2010op (5.98\u2009\u00b1\u20093.24)\u2009s (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.098); Jitter: pre\u2010op (6.12\u2009\u00b1\u20096.14)%, post\u2010op(2.39\u2009\u00b1\u20093.77)% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.090); Shimmer: pre\u2010op (22.27\u2009\u00b1\u200911.29)%, post\u2010op (13.02\u2009\u00b1\u20096.71)% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048); Grade (G): pre\u2010op (2.56\u2009\u00b1\u20090.73), post\u2010op (1.78\u2009\u00b1\u20090.44) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008); roughness (R): pre\u2010op (2.44\u2009\u00b1\u20090.73), post\u2010op (1.67\u2009\u00b1\u20090.50) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020); breathiness (B): pre\u2010op (2.11\u2009\u00b1\u20091.05), post\u2010op (1.67\u2009\u00b1\u20090.50) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.102\n                      <jats:italic>)<\/jats:italic>\n                      ; asthenia (A): pre\u2010op (1.33\u2009\u00b1\u20090.87), post\u2010op (1.00\u2009\u00b1\u20090.00) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.257); and strain (S): pre\u2010op (1.44\u2009\u00b1\u20090.88), post\u2010op (0.56\u2009\u00b1\u20090.73) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The oral CO\n                      <jats:sub>2<\/jats:sub>\n                      laser UMA is safe, minimally invasive, and highly effective. Postoperative voice quality shows significant improvement compared to the preoperative state. Moreover, the postoperative extubation rate can reach 100%, striking a balance between improving ventilation and preserving voice function to a considerable extent.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjo2.70006","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T02:23:08Z","timestamp":1741746188000},"page":"594-599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Efficacy Analysis of Unilateral Modified Arytenoidectomy for Bilateral Vocal Fold Paralysis"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8511-4151","authenticated-orcid":false,"given":"Lu","family":"Xing","sequence":"first","affiliation":[{"name":"Department of Voice Medicine Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Key Laboratory of Voice Medicine, Xiamen Science and Technology Bureau Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu\u2010Yi","family":"Zeng","sequence":"additional","affiliation":[{"name":"The School of Clinical Medicine Fujian Medical University Fuzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei\u2010Yun","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Voice Medicine Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Key Laboratory of Voice Medicine, Xiamen Science and Technology Bureau Xiamen China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2017.10.012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27001"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200409000-00009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-12-61"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e32834c1e4f"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20821"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1515"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1067\/s0892-1997(03)00066-3"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27572"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.956338"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.616"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/3601612"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198410000-00006"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2024.03.032"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2019.4863"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30885"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-60875-0"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06492-9"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2023.10.008"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-022-03589-x"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0665-1"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940511401205"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2021.103334"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215121003315"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30940"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2013.05.010"}],"container-title":["World Journal of Otorhinolaryngology - 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