Koichi Omori, MD Ashutosh Kacker, MD, David H. Slavit, MD
Stanley M. Blaugrund, MD

The goal of surgical medialization of the vocal fold is to attain complete glottic closure. The purpose of this study is to quantify the glottal gap and to examine the relationship between glottal gap and vocal function perioperatively in thyroplasty type I. Glottal gap area was measured in 20 patients at the point of maximum closure of vocal fold vibration in digitized laryngeal stroboscopic images and was normalized by the square of vocal fold length. Glottal gap area thus measured was correlated with results obtained from well-accepted acoustic, aerodynamic, and perceptual measures of vocal function. The glottal gap was significantly reduced after thyroplasty type I. In patients with small preoperative glottal gaps, the amplitude of vocal fold vibration was significantly improved. This study verifies that quantitative videostroboscopic measurement of the glottal gap is a useful means of objective evaluation of glottic incompetence and of the results of thyroplasty type I.