Vocal fold paresis – a debilitating and underdiagnosed condition

2017 ◽  
Vol 131 (S2) ◽  
pp. S48-S52 ◽  
Author(s):  
G Harris ◽  
C O'Meara ◽  
C Pemberton ◽  
J Rough ◽  
P Darveniza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vocal Fold ◽  
Speech Therapy ◽  
Clinical Signs ◽  
Vocal Fold Paralysis ◽  
Voice Handicap Index ◽  
Laryngeal Electromyography ◽  
Vocal Fold Paresis ◽  
Important Diagnostic Tool

AbstractObjectives:To review the clinical signs of vocal fold paresis on laryngeal videostroboscopy, to quantify its impact on patients’ quality of life and to confirm the benefit of laryngeal electromyography in its diagnosis.Methods:Twenty-nine vocal fold paresis patients were referred for laryngeal electromyography. Voice Handicap Index 10 results were compared to 43 patients diagnosed with vocal fold paralysis. Laryngeal videostroboscopy analysis was conducted to determine side of paresis.Results:Blinded laryngeal electromyography confirmed vocal fold paresis in 92.6 per cent of cases, with vocal fold lag being the most common diagnostic sign. The laryngology team accurately predicted side of paresis in 76 per cent of cases. Total Voice Handicap Index 10 responses were not significantly different between vocal fold paralysis and vocal fold paresis groups (26.08 ± 0.21 and 22.93 ± 0.17, respectively).Conclusion:Vocal fold paresis has a significant impact on quality of life. This study shows that laryngeal electromyography is an important diagnostic tool. Patients with persisting dysphonia and apparently normal vocal fold movement, who fail to respond to appropriate speech therapy, should be investigated for a diagnosis of vocal fold paresis.

Predicting the Outcome of Unilateral Vocal Fold Paralysis: A Multivariate Discriminating Model Including Grade of Dysphonia, Jitter, Shimmer, and Voice Handicap Index-10

2019 ◽  
Vol 128 (5) ◽  
pp. 447-452 ◽  
Author(s):  
Andrea Lovato ◽  
Maria Rosaria Barillari ◽  
Luciano Giacomelli ◽  
Lisa Gamberini ◽  
Cosimo de Filippis
Keyword(s):  
Vocal Fold ◽  
Speech Therapy ◽  
Univariate Analysis ◽  
Nearest Neighbors ◽  
Vocal Fold Paralysis ◽  
Voice Handicap Index ◽  
Misclassification Rate ◽  
Unilateral Vocal Fold Paralysis ◽  
K Nearest Neighbors ◽  
Motion Recovery

Objectives: The aim of this study was to investigate if any clinical and phoniatric characteristics or quality-of-life measures could predict the outcome of unilateral vocal fold paralysis (UVFP) initially managed with speech therapy. Methods: Forty-six patients with UVFP were evaluated using laryngostroboscopy, the GIRBAS (grade, instability, roughness, breathiness, asthenia, and strain) scale, acoustic analysis, and the Voice Handicap Index-10 (VHI-10) questionnaire. Treatment was speech therapy according to a 3-phase protocol. The main outcome measure was incomplete vocal fold mobility 12 months after symptom onset. Univariate and multivariate modeling ( k-nearest neighbors model) were applied. Results: Fifteen patients had incomplete motion recovery 12 months after the onset of UVFP. On univariate analysis, time to diagnosis (0.01), global grade of dysphonia (0.018), jitter (0.01), shimmer (0.012), and VHI-10 score (0.006) were associated with the outcome of vocal fold paralysis. Using a k-nearest neighbors multivariate discriminating model, the best discrimination of UVFP outcome was achieved with 4 parameters: global grade of dysphonia 2 or 3, jitter > 2.46%, shimmer > 6.97%, and VHI-10 score > 13. The model’s misclassification rate for incomplete motion recovery was only 6%. The model showed sensitivity of 93% and specificity of 74%. Conclusions: Delayed diagnosis and speech therapy was associated with negative outcomes. Higher grade of dysphonia, jitter, shimmer, and VHI-10 score on initial phoniatric assessment may help clinicians in predicting the outcomes of UVFP patients.

Implications of Synkinesis in Unilateral Vocal Fold Paralysis

2017 ◽  
Vol 157 (6) ◽  
pp. 1017-1024 ◽  
Author(s):  
Yu-Cheng Pei ◽  
Wei-Han Chang ◽  
Hsiu-Feng Chuang ◽  
Chia-Fen Chang ◽  
Tuan-Jen Fang
Keyword(s):  
Quality Of Life ◽  
Vocal Fold ◽  
Acoustic Analysis ◽  
Medical Center ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Cricothyroid Muscle ◽  
Related Quality ◽  
The Impact

Objectives In patients with unilateral vocal fold paralysis (UVFP), laryngeal electromyography (LEMG) occasionally observes synkinesis in laryngeal muscles, a condition that could impair vocal fold mobility and voice control. This study aims to evaluate the impact of synkinesis on UVFP patients. Study Design A retrospective case-control study. Setting Medical center. Subjects and Methods Patients with UVFP onset >6 months were recruited (N = 104). The outcome measurements included LEMG, quantitative LEMG analysis of thyroarytenoid–lateral cricoarytenoid (TA-LCA) muscle complex, glottal gap measured by videolaryngostroboscopy, voice-related quality of life, and voice acoustic analysis. Results According to the LEMG analysis, 8 patients (8%) had synkinesis, and 96 (92%) did not. In the synkinesis group, TA-LCA turn frequency in the lesioned side was comparable to that in the healthy side ( P = .52). Patients in the synkinesis group had higher TA-LCA turn frequency ( P = .001), higher probability of cricothyroid muscle dysfunction ( P = .04), and better voice-related quality of life ( P = .01) but objective voice outcomes comparable to those in the nonsynkinesis group. Conclusions Patients with synkinesis will have near-complete restoration in TA-LCA turn frequency but still experience voice impairment, a finding that is compatible with the mechanism of aberrant reinnervation. However, patients with synkinesis have better disease-related quality of life than do those without synkinesis.

The Effect of Unilateral Posterior Transverse Cordotomy on Quality of Life of Patients with Bilateral Vocal Fold Paralysis

2013 ◽  
Vol 51 (3) ◽  
pp. 83-86
Author(s):  
Fatih Celenk ◽  
Koray Tumuklu ◽  
Zeynel Abidin Karatas ◽  
Cengiz Durucu ◽  
Elif Baysal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Bilateral Vocal Fold Paralysis

scholarly journals Voice-Related Quality of Life (V-RQOL) following type I thyroplasty for unilateral vocal fold paralysis

2000 ◽  
Vol 14 (3) ◽  
pp. 378-386 ◽  
Author(s):  
Norman D. Hogikyan ◽  
Walter P. Wodchis ◽  
Jeffrey E. Terrell ◽  
Carol R. Bradford ◽  
Ramon M. Esclamado
Keyword(s):  
Quality Of Life ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Type I ◽  
Unilateral Vocal Fold Paralysis ◽  
Related Quality ◽  
Type I Thyroplasty

scholarly journals Office-Based Intracordal Hyaluronate Injections Improve Quality of Life in Thoracic-Surgery-Related Unilateral Vocal Fold Paralysis

Medicine ◽  
2015 ◽  
Vol 94 (40) ◽  
pp. e1787 ◽  
Author(s):  
Tuan-Jen Fang ◽  
Li-Jen Hsin ◽  
Hsiu-Feng Chung ◽  
Hui-Chen Chiang ◽  
Hsueh-Yu Li ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thoracic Surgery ◽  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Improve Quality ◽  
Unilateral Vocal Fold Paralysis

scholarly journals Hyaluronic Acid Injection Laryngoplasty for Unilateral Vocal Fold Paralysis—A Systematic Review and Meta-Analysis

Cells ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 2417
Author(s):  
Chen-Chi Wang ◽  
Shang-Heng Wu ◽  
Yu-Kang Tu ◽  
Wen-Jiun Lin ◽  
Shih-An Liu
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Hyaluronic Acid ◽  
Vocal Fold ◽  
Meta Analysis ◽  
Vocal Fold Paralysis ◽  
Injection Laryngoplasty ◽  
Unilateral Vocal Fold Paralysis

Unilateral vocal fold paralysis (UVFP) is a common disorder that may cause glottal closure insufficiency and then hoarseness of voice and aspiration during swallowing. We conducted a systematic review and meta-analysis to evaluate whether hyaluronic acid (HA) injection laryngoplasty (IL) is an effective treatment for patients with UVFP. Comprehensive systematic searches were undertaken using PubMed, EBSCO Medline, and Cochrane Library databases. We appraised the quality of studies according to preset inclusion and exclusion criteria. The lengths of follow-up were divided into “short-term” (3 months or shorter), “medium-term” (6 months), and “long-term” (12 months or longer). We performed random-effect meta-analysis to estimate the changes in voice-related quality of life, perceptual evaluation by grading systems, voice lab analysis of maximal phonation time, and normalized glottal gap area, before and after HA IL. Fourteen studies were eligible for the final analysis. The results showed that patients’ glottal closure insufficiency could be improved; maximal phonation time could be prolonged; perceptual evaluations of the voice and quality of life were better after HA IL, but the duration of treatment effect varied among different studies. In conclusion, HA IL is an effective treatment for UVFP, which may achieve a long-term effect and therefore reduce the likelihood of requiring permanent medialization thyroplasty.

Modified arytenoid adduction for cancer-related unilateral vocal fold paralysis

2010 ◽  
Vol 125 (2) ◽  
pp. 173-180
Author(s):  
J Shi ◽  
S Chen ◽  
D Chen ◽  
W Wang ◽  
S Xia ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vocal Fold ◽  
Voice Quality ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Patients With Cancer ◽  
Arytenoid Adduction ◽  
Aerodynamic Parameters ◽  
The Impact

AbstractObjectives:(1) To evaluate the efficacy of modified arytenoid adduction in the management of patients with symptomatic cancer-related unilateral vocal fold paralysis, and (2) to assess the impact of this treatment on patients' quality of life.Methods:Forty-two patients with cancer-related unilateral vocal fold paralysis underwent modified arytenoid adduction between February 2001 and December 2008. Of these, 37 patients were enrolled in this retrospective study (one patient died of primary disease and four were lost to follow up). Laryngostroboscopy was performed to evaluate vocal fold orientation and mobility. Pre- and post-operative assessment of subjective and objective voice, aerodynamic parameters, and quality of life were also undertaken, and aspiration was subjectively rated.Results:Laryngostroboscopic findings indicated a significant post-operative improvement in vocal fold posterior glottal closure and vertical gap. Significant improvements in voice quality, aerodynamic parameters and quality of life were noted three months post-operatively in all patients (p < 0.01). The overall success rate for swallowing rehabilitation was 94.6 per cent (35/37). Subjective aspiration ratings decreased significantly post-operatively, compared with pre-operative values (p < 0.01). No major complication occurred in any patient, except for dyspnoea in one patient.Conclusion:Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.

Assessment of the quality of life in the treatment approaches of patients with the comorbid course of arterial hypertension and metabolic disorders aimed at reducing cardiovascular risk

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
V Zlatkina ◽  
V Shkapo ◽  
A Nesen ◽  
T Starchenko
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Arterial Hypertension ◽  
Metabolic Disorders ◽  
Clinical Signs ◽  
Blood Analysis ◽  
Sf 36 ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction. Cardiovascular diseases (CVD) remain the leading cause of premature death worldwide. According to epidemiological studies CVD prevention is highly effective. A 50% reduction in mortality from coronary artery disease (CAD) is associated with exposure to risk factors and only 40% with improved treatment. Purpose.  To assess the quality of life (QOL) in patients with arterial hypertension (AH) and metabolic disorders, to establish its impact on therapy effectiveness. We examined 280 patients with AH and comorbidity - 171 women and 109 men aged 45-75 years. Along with AH, all patients had comorbidities: 72.6 % suffered from coronary artery disease (CAD), 10.5% after myocardial infarction (MI), 35 % had clinical signs of heart failure (HF), 22, 1% - type 2 diabetes mellitus (t2DM), 27.4% - chronic kidney disease (CKD). Methods. Anthropometry, blood pressure (BP) measurement, immunoassay (C-reactive protein), biochemical blood analysis (lipid, carbohydrate metabolism parameters, QOL determination (questionnaire Sf-36). Results. In patients with comorbidity of pathologies (presence of AH, t2DM, CKD, CAD, obesity), there was a decrease in assessments in almost all indicators of QOL, and especially significant limitations in the performance of daily activities due to both physical and mental state. Conclusion. The degree of AH in patients with t2DM decreased QOL of physical activity, role-physical functioning, pain and general health, reflecting physical health, as well as mental health, including vitality, social activity, role emotional functioning. T2DM in patients with AH significantly worsens QOL of this category of patients as in physical component summary and mental component summary. The indicators of QOL are significantly affected by the duration of t2DM, as well as the degree of compensation. Achievement of the target BP levels in patients with AH with t2DM shows an improvement in a number of QOL parameters and makes it possible to recommend the Sf-36 questionnaire as a criterion for the effectiveness of the therapy.

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