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Unilateral Vocal Fold Paralysis

Juliana Bonilla-Velez, Mariah Small, Francisco J Bonilla-Escobar, Matthew Sharum, Ozlem E Tulunay-Ugur
Objective To compare voice and swallowing outcomes after treatment in younger adult (<65 years) and geriatric (≥65 years) patients with unilateral vocal fold paralysis (UVFP). Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods The cases of patients presenting to a tertiary voice clinic with UVFP between June 2005 and February 2015 were reviewed. Clinical characteristics and outcomes in a geriatric subset were compared with those in younger adult group. Results A total of 206 patients met our inclusion criteria (n = 110, <65 years; n = 96, ≥65 years)...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Steven A Zuniga, Barbara Ebersole, Nausheen Jamal
Objective Examine the incidence of penetration/aspiration in patients with unilateral vocal fold immobility and investigate the relationship with self-reported perception of dysphagia. Study Design Case series with chart review. Setting Academic cancer center. Subjects and Methods Adult patients with unilateral vocal fold immobility diagnosed between 2014 and 2016 were reviewed. Patients were stratified into an aspiration group and a nonaspiration group using objective findings on flexible endoscopic evaluation of swallowing, as scored using Rosenbek's Penetration Aspiration Scale...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Daniel J Croake, Richard D Andreatta, Joseph C Stemple
Purpose: The purpose of this study is to quantify the interactions of the 3 vocalization subsystems of respiration, phonation, and resonance before, during, and after a perturbation to the larynx (temporarily induced unilateral vocal fold paralysis) in 10 vocally healthy participants. Using dynamic systems theory as a guide, we hypothesized that data groupings would emerge revealing context-dependent patterns in the relationships of variables representing the 3 vocalization subsystems...
February 27, 2018: Journal of Speech, Language, and Hearing Research: JSLHR
Chloe Walton, Paul Carding, Kieran Flanagan
PURPOSE OF REVIEW: Unilateral vocal fold paralysis (UVFP) is a common cause of neurogenic dysphonia resulting in glottal insufficiency. To restore glottal sufficiency and reduce the presenting dysphonia, treatment involving either surgical intervention, voice therapy or a combination of the two is typically provided. Currently, there is no consensus for the most effective voice treatment for UVFP. This results in an inability to compare current studies, and a lack of treatment effectiveness for the management of UVFP...
February 19, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
T N Chao, A Mahmoud, K Rajasekaran, N Mirza
BACKGROUND: Medialisation thyroplasty is considered the 'gold standard' treatment for unilateral vocal fold paralysis, enabling improvement of voice and swallowing function, and preventing life-threatening aspiration events. The most commonly used laryngeal implants induce some degree of local tissue inflammatory response, and carry the risk of immediate or delayed implant extrusion. METHODS: This paper describes a novel approach for medialisation thyroplasty. Specifically, it utilises a ribbon of autologous tensor fascia lata harvested at the time of surgery...
February 21, 2018: Journal of Laryngology and Otology
SeungWon Lee, KiNam Park
OBJECTIVES: This study compared and assessed long-term voice outcomes when thyroidectomy-related unilateral vocal fold paralysis (VFP) was managed using injection laryngoplasty (IL) and recurrent laryngeal nerve reinnervation (RLNR). STUDY DESIGN: Prospective clinical study. METHODS: A prospective clinical trial was performed from March 2005 to January 2016 at Soonchunhyang University Bucheon Hospital (Bucheon, South Korea). Nineteen patients who underwent ansa cervicalis to RLNR or direct reinnervation, and 43 patients who underwent IL to treat thyroidectomy-related unilateral VFP, were enrolled...
February 16, 2018: Laryngoscope
Ming-Shao Tsai, Yao-Hsu Yang, Chia-Yen Liu, Meng-Hung Lin, Geng-He Chang, Yao-Te Tsai, Hsueh-Yu Li, Ying-Huang Tsai, Cheng-Ming Hsu
Objective To investigate pneumonia risk among patients with unilateral vocal fold paralysis (UVFP). Study Design Retrospective population-based cohort study. Setting This study used data from the National Health Insurance Research Database of Taiwan, a nationwide population-based database. Subjects and Methods A total of 419 patients newly diagnosed with UVFP between January 1, 1997, and December 31, 2013, were identified from the Longitudinal Health Insurance Database 2000, a nationally representative database of 1 million randomly selected patients...
January 1, 2018: Otolaryngology—Head and Neck Surgery
F Rubin, A Villeneuve, L Alciato, L Slaïm, P Bonfils, O Laccourreye
GOAL: To analyze the characteristics of adult idiopathic unilateral vocal-fold paralysis. MATERIAL AND METHODS: Retrospective study of diagnostic problems, clinical data and recovery in an inception cohort of 100 adult patients with idiopathic unilateral vocal-fold paralysis (Group A) and comparison with a cohort of 211 patients with isolated non-idiopathic non-traumatic unilateral vocal-fold paralysis (Group B). RESULTS: Diagnostic problems were noted in 24% of cases in Group A: eight patients with concomitant common upper aerodigestive tract infection, five patients with a concomitant condition liable to induce immunodepression and 11 patients in whom a malignant tumor occurred along the path of the ipsilateral vagus and inferior laryngeal nerves or in the ipsilateral paralyzed larynx...
February 2, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Thomas Schweiger, Konrad Hoetzenecker, Imme Roesner, Berit Schneider-Stickler, Doris-Maria Denk-Linnert, Walter Klepetko
OBJECTIVES: Bilateral vocal fold paralysis (VFP) is a severe complication after laryngotracheal (LT) surgery. The reduced glottic opening leads to significant respiratory distress immediately after the operation and requires the placement of a tracheostomy in most cases. Patients with a pre-existing unilateral VFP or expected recurrent nerve resection are at the highest risk for glottic failure. These patients might benefit from a pre-emptive glottic enlargement before LT surgery. METHODS: We performed a retrospective review of patients who received a pre-emptive glottis enlargement before LT surgery at the Medical University of Vienna from October 2011 to December 2016...
February 1, 2018: European Journal of Cardio-thoracic Surgery
A Mattei, G Desuter, M Roux, B-J Lee, M-A Louges, E Osipenko, B Sadoughi, B Schneider-Stickler, A Fanous, A Giovanni
There is a growing need for evaluation tools allowing the quantification of the outcome after voice surgeries. Since the end of the 1990s, multiple unfruitful attempts have been made to reach a consensus, including the Dejonckere protocol for the European Laryngological Society in 2001. This suggested to perform objective and quantifiable measures in the following domains: perception, acoustic, aerodynamic, self-evaluation by the patient and videolaryngostroboscopy. But in a PubMed® search with the keywords "Voice Assessment" and "Voice Outcome" since 2001 retrieving 452 articles, only 33 of them were using methods taking into account the first four dimensions proposed by Dejonckere...
February 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Ashley P O'Connell Ferster, Michael C Ferster, Haley Glatthorn, Bartholomew J Bacak, Robert T Sataloff
OBJECTIVES: This study aims to assess utility of pixel-valued movement software in detecting arytenoid dislocation preoperatively. STUDY DESIGN: This is a retrospective analysis. METHODS: Twenty-seven patients diagnosed with unilateral arytenoid dislocation were included. Diagnosis of arytenoid dislocation was confirmed by lack of vocal fold paralysis on preoperative laryngeal electromyography and by intraoperative findings of cricoarytenoid dislocation...
January 24, 2018: Journal of Voice: Official Journal of the Voice Foundation
In-Ho Bae, Soo-Geun Wang, Jin-Choon Lee, Eui-Suk Sung, Seong-Tae Kim, Yeon-Woo Lee, Duck-Hoon Kang, Yong-Jin Wang
OBJECTIVE: The purpose of this study was to evaluate the clinical feasibility and diagnostic accuracy of two-dimensional scanning digital kymography (2D DKG) in patients with vocal cord atrophy before and after treatment. MATERIALS AND METHODS: We analyzed the characteristics of vocal fold vibration in five patients with unilateral vocal fold paralysis and five patients with presbyphonia. In patients with vocal cord paralysis, the status before and after intracordal injection was compared...
January 29, 2018: Journal of Voice: Official Journal of the Voice Foundation
Peter M Vila, Neel K Bhatt, Randal C Paniello
OBJECTIVE: To determine whether injection laryngoplasty within 6 months following the onset of unilateral vocal fold paralysis (UVFP) decreases the rate of permanent thyroplasty in adults. DATA SOURCES: Search strategies created by a medical librarian were implemented in multiple online research databases. REVIEW METHODS: Inclusion and exclusion criteria were designed to capture randomized clinical trials and cohort studies examining adults with UVFP who received injection laryngoplasty early in the course of treatment, within 6 months of onset, or who were observed...
January 22, 2018: Laryngoscope
R Jun Lin, Libby J Smith, Michael C Munin, Shaum Sridharan, Clark A Rosen
OBJECTIVE: Treatment options for symptomatic unilateral vocal fold paralysis (VFP) include vocal fold augmentation, laryngeal framework surgery, and laryngeal reinnervation. Laryngeal reinnervation (LR) has been suggested to provide "tone" to the paralyzed VF. This implies a loss of tone as a result of denervation without reinnervation. We performed laryngeal electromyography (LEMG) in patients with chronic VFP to understand the innervation status associated with a chronically paralyzed vocal fold...
January 22, 2018: Laryngoscope
Leonardo Riedi de Andrade, Yara Marcondes Machado Castiglia
BACKGROUND AND OBJECTIVE: Some surgical procedures such as laryngoplasty require patients to remain conscious during the intraoperative phase in order to enable speech monitoring. Dexmedetomidine and remifentanil were used in this study, since they promote appropriate patient collaboration with facilitated awakening, and are rapidly eliminated. CASE REPORT: The patient complained of dysphonia, which had resulted from unilateral vocal fold paralysis after previous thyroidectomy...
January 5, 2018: Revista Brasileira de Anestesiologia
Naoki Nishio, Yasushi Fujimoto, Mariko Hiramatsu, Takashi Maruo, Kenji Suga, Hidenori Tsuzuki, Nobuaki Mukoyama, Mariko Shimono, Kazuhiro Toriyama, Keisuke Takanari, Yuzuru Kamei, Michihiko Sone
Objective: To perform a quantitative computed tomography (CT) assessment of short- and long-term outcomes of autologous fat injection augmentation in patients with unilateral vocal fold paralysis. Study Design: Retrospective case series. Methods: Twelve patients who had undergone autologous fat injection augmentation for unilateral vocal fold paralysis in our hospital between 2011 and 2015 were enrolled in this study. The autologous fat for injection was acquired from periumbilical subcutaneous tissue and was injected orally using a special-purpose laryngeal injection needle...
December 2017: Laryngoscope Investigative Otolaryngology
Yong-Sug Choi, Young-Hoon Joo, Young-Hak Park, Sang-Yeon Kim, Dong-Il Sun
BACKGROUND: We used voice analysis and clinicopathological factors to explore the prognosis of unilateral vocal fold paralysis after thyroid surgery. METHODS: The medical records of 63 females who developed unilateral vocal fold paralysis after thyroidectomy were reviewed. All patients were divided into two groups: those who recovered from vocal fold paralysis and those who did not. We analyzed clinical parameters and voice analysis results in a search for correlations with recovery from paralysis...
December 30, 2017: World Journal of Surgery
Karen B Zur, Linda M Carroll
Pediatric aspiration is a multifactorial process that is often complex to manage. Recurrent laryngeal nerve (RLN) injury can cause glottic insufficiency and aspiration. We describe three cases of unilateral vocal fold paralysis resulting in aspiration and the successful use of the RLN reinnervation for its treatment. The theory for utilizing the reinnervation procedure is that when glottic closure improves and a less breathy vocalization occurs, then the larynx is better equipped to protect the lower airway and avoid aspiration...
January 2018: International Journal of Pediatric Otorhinolaryngology
Priatharisiny Velayutham, Alexandria L Irace, Kosuke Kawai, Pamela Dodrill, Jennifer Perez, Monica Londahl, Lauren Mundy, Natasha D Dombrowski, Reza Rahbar
OBJECTIVE: To determine the prevalence of silent aspiration in pediatric patients and identify which diagnoses may be associated with this finding. METHODS: An institutional review board-approved retrospective review was conducted for all patients under the age of 18 who underwent modified barium swallow (MBS) studies at a tertiary children's hospital in 2015. Speech-language pathologists reviewed MBS studies to identify aspiration/silent aspiration on each fluid consistency tested...
December 27, 2017: Laryngoscope
Jin-Choon Lee, Soo-Geun Wang, Eui-Suk Sung, In-Ho Bae, Seong-Tae Kim, Yeon-Woo Lee
BACKGROUND: A digital kymogram shows real images of vocal fold vibration. However, DKG is difficult to use in clinical practice because the recorded image cannot be seen instantaneously after examination, as considerable encoding time is required to visualize a digital kymogram. In addition, frame-by frame analysis should be implemented to evaluate high-speed videoendoscopy data, but is time- and labor-intensive. PURPOSE: The purpose of the study was to validate the clinical practicability of a real-time multislice digital kymographic system developed by the authors...
December 22, 2017: Journal of Voice: Official Journal of the Voice Foundation
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