Correlation Between Vocal Tract Dimensions and Patient Tolerance in Office-Based Laryngeal Surgery.

Abstract

To analyze the correlation between vocal tract dimensions and patient tolerance to office-based laryngeal surgery (OBLS) using the transnasal approach. The medical records and video-recordings of all patients who underwent OBLS between September 2024 and May 2025 were reviewed. Only patients who had a pre-operative computed tomography (CT) scan of the neck and had filled out the IOWA tolerance questionnaire were included in this study. A total of 11 anatomical measurements of the upper airway were evaluated. These included: Velum Length, vertical position of the larynx, distance from nostril to the vocal folds, distance from nostril to hard/Soft palate junction, distance from nostril to posterior nasopharyngeal mucosa, nasopharyngeal width, length of the oral component of the vocal tract, velopharyngeal width, oropharyngeal width, opening of the Hypopharynx, hypopharyngeal width. Patient tolerance to the procedure was assessed using the IOWA Satisfaction with Anesthesia Scale, which ranges between -3 and +3 (completely satisfied). Twenty patients, with a mean age of 62.55 ± 14.93 years, were included. The most common voice diagnosis was unilateral vocal fold paralysis (60%), followed by laryngeal squamous cell carcinoma (25%). The most commonly performed procedures were injection laryngoplasty (65%) and laryngeal biopsy (15%). There was a moderate negative correlation between velum length and IOWA scores (r = -0.568, p = 0.009). There was no statistically significant correlation between any other vocal tract measurements and IOWA scores. This investigation showed that the longer the velum, the lower the tolerance score for office-based laryngeal surgery.