A Clinical Audit of the Investigation and Follow-up of Vocal Fold Paralysis at Rigshospitalet, Denmark

2019 ◽  
Vol 2 (1) ◽  
pp. 52-56
Author(s):  
Lars Iversen ◽  
Jesper Storgård Balle ◽  
Ramon Gordon Jensen
Keyword(s):  
Vocal Fold ◽  
Clinical Audit ◽  
Vocal Fold Paralysis

Arytenoidopexy for bilateral vocal fold paralysis in young children

1996 ◽  
Vol 110 (11) ◽  
pp. 1027-1030 ◽  
Author(s):  
Jean-Michel Triglia ◽  
Jean-François Belus ◽  
Richard Nicollas
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Young Children ◽  
Vocal Fold ◽  
Good Health ◽  
Vocal Fold Paralysis ◽  
Airway Compromise ◽  
Bilateral Vocal Fold Paralysis ◽  
Life Threatening

AbstractThe purpose of this retrospective study was to describe and evaluate the results of arytenoidopexy performed by the external laterocervical approach in 15 consecutive children presenting bilateral vocal fold paralysis causing life-threatening airway compromise. Mean age at the time of surgery was 20 months and mean follow-up was 42 months. At the end of follow-up all patients were in good health and did not need special care for breathing. No abduction movement has been observed on the opposite vocal fold since arytenoidopexy. One failure subsequently required arytenoidectomy. The findings of this study suggest that arytenoidopexy is an effective surgical treatment for life-threatening bilateral vocal fold paralysis in young children.

Vocal fold paralysis following carotid endarterectomy

1999 ◽  
Vol 113 (5) ◽  
pp. 439-441 ◽  
Author(s):  
Fernanda I. Espinoza ◽  
Fiona B. MacGregor ◽  
Julie C. Doughty ◽  
Lynn D. Cooke
Keyword(s):  
Vagus Nerve ◽  
Carotid Endarterectomy ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Indirect Laryngoscopy ◽  
One Year ◽  
Operative Assessment

AbstractInjury to the vagus nerve or one of its branches during carotid endarterectomy (CEA) can result in vocal fold paralysis (VFP). This study assessed prospectively 73 patients undergoing CEA. A total of 76 procedures were performed in these patients over a one-year period. All patients underwent preoperative and post-operative assessment of vocal fold mobility by indirect laryngoscopy and/or flexible nasendoscopy. All patients had normal vocal fold mobility pre-operatively. Eight patients (10 per cent) complained of hoarseness after surgery and in three patients (four per cent) examination confirmed an ipsilateral VFP. This persists in all three patients at six-month follow-up. Vocal fold assessment is important in patients undergoing CEA, particularly when performing second side surgery. We recommend that patients should be informed of the risk of VFP following CEA when obtaining consent.

Results of Fascial Augmentation in Unilateral Vocal Fold Paralysis

2002 ◽  
Vol 111 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Petri Reijonen ◽  
Sari Lehikoinen-Söderlund ◽  
Heikki Rihkanen
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Inexpensive Method ◽  
Maximum Phonation Time ◽  
Perceptual Evaluation

The objective of this study was to evaluate the effects on voice quality of augmentation by injection of minced fascia in patients with unilateral vocal fold paralysis. Preoperative and postoperative voice samples from 14 patients (6 men and 8 women; mean age, 59 years) were analyzed by computerized acoustic analysis and blinded perceptual evaluation. Statistically significant improvements were seen in perturbation measurements (jitter and shimmer), noise-to-harmonics ratio, and maximum phonation time. A panel of evaluators rated 10 of the 14 postoperative voices as normal or near-normal. Injection laryngoplasty with minced fascia offers a new, effective, well-tolerated, and inexpensive method to medialize a paralyzed vocal fold. The graft seems to survive well, as indicated by good vocal results with a follow-up ranging from 5 to 32 months.

Quality of Voice and Prognostic Markers for the Recovery of Vocal Fold Paralysis After Thyroid Surgery

2019 ◽  
Vol 128 (12) ◽  
pp. 1104-1110 ◽  
Author(s):  
Rudolf Reiter ◽  
Adrienne Heyduck ◽  
Thomas Karl Hoffmann ◽  
Sibylle Brosch ◽  
Maria Anna Buchberger ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Vocal Fold ◽  
Complete Recovery ◽  
Vocal Fold Paralysis ◽  
Predicting Factors ◽  
Quality Of Voice ◽  
Thyroid Gland Surgery ◽  
The Voice

Objectives: This study is set to analyze clinicopathological factors predicting the recovery of unilateral vocal fold paralysis (UVP) in patients after thyroid gland surgery. The quality of voice was additionally assessed in these patients. Methods: The charts and videolaryngostroboscopy (VLS) examinations of 84 consecutive patients with a complete UVP after surgery of the thyroid gland were retrospectively reviewed. Patients were divided into 2 groups: patients who fully recovered from vocal fold paralysis and those who failed to recover after a follow-up of 12 months. The quality of voice was analyzed among other things by determining the Voice Handicap Index (VHI). Results: The UVP fully recovered in 52 of 84 (61.9%) patients. Positive mucosal waves (pMWs) on the paralyzed side, a minimal glottic gap <3 mm seen at the first postoperative VLS, age ≤50 years, and surgery duration ≤120 minutes were associated factors for a complete recovery of nerve function. The voice parameters improved independently from recovery of the paralysis in 90% of the patients. Conclusions: For patients with a poor prognosis of a UVP, early intervention may be beneficial. Thus, predicting factors for a full recovery of vocal fold motion would be a valuable tool. In our cohort, about 60% of recoveries could have been predicted using the above-mentioned parameters. Good quality of voice was independently reached in 90% of the cases.

Long-Term Results of Nerve-Muscle Pedicle Reinnervation for Laryngeal Paralysis

1989 ◽  
Vol 98 (9) ◽  
pp. 674-676 ◽  
Author(s):  
Harvey M. Tucker
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Long Term Results ◽  
Bilateral Group ◽  
Bilateral Vocal Fold Paralysis ◽  
Cricoarytenoid Arthritis ◽  
Nerve Muscle ◽  
Unilateral Group

Between 1976 and 1986, 214 patients with bilateral vocal fold paralysis and 73 patients with unilateral vocal fold paralysis were managed by the author using the nerve-muscle pedicle technique for reinnervation. Follow-up of at least 2 years has been obtained on 202 of the bilaterally and 70 of the unilaterally involved patients. Long-term success has been achieved in 74% of the bilateral group and 88% of the unilateral group. Successful reinnervation of unilateral paralyses usually maintains voice correction indefinitely, but there is late (2 to 5 years postsurgery) deterioration of successful airway restoration in approximately 17% of bilateral cases, which appears to be due to development of cricoarytenoid arthritis.

S191 – Unilateral Vocal Fold Paralysis: Medialization Results

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P191-P192
Author(s):  
Donna Lundy ◽  
Roy R Casiano ◽  
Mario Alberto Landera ◽  
Michael Bublik
Keyword(s):  
Vocal Fold ◽  
Demographic Data ◽  
Vocal Fold Paralysis ◽  
Long Term Results ◽  
Unilateral Vocal Fold Paralysis ◽  
Glottal Closure ◽  
Voice Outcome ◽  
Glottal Insufficiency

Objectives Management of glottal insufficiency due to unilateral vocal fold paralysis (UVFP) has evolved from trans-oral injection to external thyroplasty to revisited injections (transoral or transcutaneous). Currently, preference is given to the less invasive injection medialization. Multiple injectable materials have been utilized with newer ones being introduced to manage concerns over permanency and vocal fold vibratory patterns. The purpose of this study is to evaluate the long-term results of injection medialization for UVFP in terms of stability of glottal closure and voice outcome vs. need for reinjection. Methods All patients with UVFP that underwent injection medialization and had follow-up studies more than 6 months were eligible for inclusion. Parameters studied included demographic data (age, gender), side of paralysis, etiology, degree of pre-injection glottal insufficiency, length of follow-up, degree of post-injection glottal closure, mucosal wave resolution, and Voice Handicap Index. Results 146 patients were identified with a mean age of 61.7 years (17–94); males (55%) and females (45%). Etiology was idiopathic (56%); iatrogenic (48%); tumor-related (9%); trauma (3%); and neurologic (2%). Degree of glottal insufficiency was mild (21%); moderate (29%); and severe (50%). Material injected was Cymetra in 80 patients and Radiesse in 66 patients. 45 (33%) patients underwent more than 1 injection. Details of patients requiring repeat injections with regards to the material injected and the other parameters will be presented. Conclusions Injection medialization via a transcutaneous approach has long-lasting results making it an appropriate minimally-invasive option for long-term medialization for UVFP.

Recommendations on follow-up strategies for idiopathic vocal fold paralysis: evidence-based review

2012 ◽  
Vol 126 (6) ◽  
pp. 570-573 ◽  
Author(s):  
A Tsikoudas ◽  
V Paleri ◽  
M Reda El-Badawey ◽  
I Zammit-Maempel
Keyword(s):  
Vocal Fold ◽  
English Language ◽  
Vocal Fold Paralysis ◽  
Database Search ◽  
Warning Sign ◽  
Evidence Based ◽  
Laryngeal Pathology ◽  
Early Warning Sign ◽  
Diagnostic Modalities

AbstractIntroduction:Vocal fold paralysis can be an early warning sign of serious extra-laryngeal pathology. Even if imaging investigations show no pathology, there is always concern about the emergence of new pathology in the future. There is currently no consensus on the best follow-up protocol for vocal fold paralysis patients with no abnormalities on investigation.Methods:Systematic review, using an Ovid and Medline database search of papers written in the English language and published in the last 20 years.Results:Eight relevant studies were identified. Not all of them were directly comparable. A narrative review of the studies is presented and conclusions are drawn.Conclusion:Current diagnostic modalities are sufficiently reliable and sensitive to diagnose any significant existing extra-laryngeal pathology. Thus, once initial investigation (including computed tomography) has concluded, no further follow up is necessary.

Novel Approach of Medialization Thyroplasty with Arytenoid Adduction Performed under General Anesthesia with a Laryngeal Mask

2011 ◽  
Vol 146 (2) ◽  
pp. 266-271 ◽  
Author(s):  
Nicholas W. Stow ◽  
Jennifer W. Lee ◽  
Ian E. Cole
Keyword(s):  
Vocal Fold ◽  
Case Series ◽  
Vocal Fold Paralysis ◽  
Laryngeal Mask ◽  
Unilateral Vocal Fold Paralysis ◽  
Maximum Phonation Time ◽  
Arytenoid Adduction ◽  
Medialization Thyroplasty ◽  
The Voice

Objective. To objectively assess the voice outcomes of patients with unilateral vocal fold paralysis treated with medialization thyroplasty and arytenoid adduction suture. Study Design. Case series of patients who underwent medialization thyroplasty and arytenoid adduction suture. Preoperative and postoperative voice testing was performed and the data were compared by statistical analysis. Setting. Tertiary referral teaching hospital in Sydney, Australia. Subjects. All patients had a unilateral vocal fold paralysis, with a large posterior glottic gap and vocal symptoms affecting their quality of life. Methods. Thirteen patients with a diagnosis of a unilateral vocal fold paralysis with a large posterior glottic gap, vocal symptoms, and total denervation of the vocal fold underwent medialization thyroplasty and arytenoid adduction suture. The surgery was performed in a novel method under a general anesthetic using a laryngeal mask and with direct intraoperative endoscopic feedback. Preoperative and postoperative measures of voice performance were compared, including acoustic analysis (fundamental frequency, speech intensity against quiet and loud background noise, speech rate) and aerodynamic assessment (airflow, maximum phonation time). Results. Medialization thyroplasty with arytenoid adduction suture significantly improved aerodynamic assessment and phonation duration for both male and female subjects overall. There were 2 of 13 treatment failures. Median follow-up time was 6 months. Conclusion. Preliminary results indicate that in selected patients with vocal fold paralysis, medialization thyroplasty with arytenoid adduction suture leads to significant improvements in objective voice measures. Longer follow-up data are required to further quantify the voice outcomes after this procedure.

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