Unilateral Vocal Fold Paralysis: The “Trifecta”—Dysphonia, Dysphagia, and Dyspnea

2021 ◽  
pp. 1-4
Author(s):  
Michelle Adessa
Keyword(s):  
Treatment Planning ◽  
Case History ◽  
Vocal Fold ◽  
Clinical Case ◽  
Acoustic Analysis ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Voice Assessment ◽  
Perceptual Analysis ◽  
Audio Files

Purpose: A clinical case of unilateral vocal fold paralysis is presented with case history, auditory-perceptual analysis and accompanying audio files and ratings, videostroboscopic files and ratings, and acoustic analysis, as well as impressions and plan for treatment. Method: A single clinical case of unilateral vocal fold paralysis is presented for learning purposes. Results: Clinical keys are provided for learning. Conclusion: Learners will be able to follow a clinical case to aid in perceptual, videostroboscopic, acoustic, and voice assessment and goal and treatment planning. Supplemental Material https://doi.org/10.23641/asha.16799563

scholarly journals Using Innovative Acoustic Analysis to Predict the Postoperative Outcomes of Unilateral Vocal Fold Paralysis

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yung-An Tsou ◽  
Yi-Wen Liu ◽  
Wen-Dien Chang ◽  
Wei-Chen Chen ◽  
Hsiang-Chun Ke ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Linear Prediction ◽  
Acoustic Analysis ◽  
Characteristic Curve ◽  
Voice Quality ◽  
Treatment Strategies ◽  
Vocal Fold Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Outcome Predictor ◽  
Laryngeal Framework Surgery

Objective.Autologous fat injection laryngoplasty is ineffective for some patients with iatrogenic vocal fold paralysis, and additional laryngeal framework surgery is often required. An acoustically measurable outcome predictor for lipoinjection laryngoplasty would assist phonosurgeons in formulating treatment strategies.Methods.Seventeen thyroid surgery patients with unilateral vocal fold paralysis participated in this study. All subjects underwent lipoinjection laryngoplasty to treat postsurgery vocal hoarseness. After treatment, patients were assigned to success and failure groups on the basis of voice improvement. Linear prediction analysis was used to construct a new voice quality indicator, the number of irregular peaks (NIrrP). It compared with the measures used in the Multi-Dimensional Voice Program (MDVP), such as jitter (frequency perturbation) and shimmer (perturbation of amplitude).Results.By comparing the [i] vowel produced by patients before the lipoinjection laryngoplasty (AUC = 0.98, 95% CI = 0.78–0.99), NIrrP was shown to be a more accurate predictor of long-term surgical outcomes than jitter (AUC = 0.73, 95% CI = 0.47–0.91) and shimmer (AUC = 0.63, 95% CI = 0.37–0.85), as identified by the receiver operating characteristic curve.Conclusions.NIrrP measured using the LP model could be a more accurate outcome predictor than the parameters used in the MDVP.

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.

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.

scholarly journals Can preoperative results predict the need for future reintervention following injection laryngoplasty for unilateral vocal fold paralysis?

2021 ◽  
Author(s):  
Beata Miaśkiewicz ◽  
Aleksandra Panasiewicz ◽  
Elżbieta Gos ◽  
Paulina Krasnodębska ◽  
Piotr H. Skarżyński ◽  
...  
Keyword(s):  
Relative Risk ◽  
Vocal Fold ◽  
Statistical Significance ◽  
Vocal Fold Paralysis ◽  
Control Group ◽  
Study Group ◽  
Injection Laryngoplasty ◽  
Unilateral Vocal Fold Paralysis ◽  
Voice Assessment ◽  
The Difference

Abstract Purpose The objective was to investigate whether a patient’s preoperative test results can predict the need for future reoperation in unilateral vocal fold paralysis (UVFP). Methods A single-centre retrospective study was performed. The study group consisted of 18 patients with UVFP who had been treated with injection laryngoplasty but who required further treatment and were augmentated again within 36 months. The control group consisted of 33 injected patients who had not required reintervention up to 36 months later. Results Only glottal gap was associated with a relative risk for reinjection. Glottal gap was found to be severe in 77.8% of the patients from the study group compared to 42.4% of the controls, and the difference was statistically significant. The kind of injected material (calcium hydroxylapatite or hyaluronic acid), age, and voice assessment (perceptual, objective, or subjective) did not seem to affect the likelihood of reoperation being needed. There were no between-group statistically significant differences in individual aspects of the GRBAS scale. The global score was slightly higher in the study group, but it did not reach statistical significance (U = 198.5; p = 0.09). A comparison of VHI scores did not yield statistically significant differences between the study and control groups. No significant differences in objective acoustic voice parameters were observed between the groups. Conclusion Only glottal gap occurred to be associated with a relative risk for reinjection. A kind of injected material (CaHA or HA), age, perceptual, objective and subjective voice assessment do not seem to impact the likelihood of reoperation in patients with UVFP.

Comparative study of framework surgery and fat injection laryngoplasty

2009 ◽  
Vol 123 (S31) ◽  
pp. 35-41 ◽  
Author(s):  
H Umeno ◽  
S Chitose ◽  
K Sato ◽  
T Nakashima
Keyword(s):  
Comparative Study ◽  
Vocal Fold ◽  
Acoustic Analysis ◽  
Functional Results ◽  
Vocal Fold Paralysis ◽  
Injection Laryngoplasty ◽  
Unilateral Vocal Fold Paralysis ◽  
Fat Injection ◽  
Autologous Fat ◽  
Before And After

AbstractObjective:To evaluate differences between the functional results of framework surgery and autologous fat injection laryngoplasty, for patients with unilateral vocal fold paralysis.Study design:Sixty-two patients underwent framework surgery, while 64 received autologous fat injection laryngoplasty. Voice function before and after both procedures was assessed using aerodynamic and acoustic analysis, with differences evaluated using paired t-test in both groups.Results:In both groups, all parameters improved significantly after surgery, compared with before surgery. Post-operative improvement in all parameters was significantly greater after fat injection laryngoplasty, compared with framework surgery.Conclusion:Autologous fat injection laryngoplasty was thus found to be a more effective and reliable therapy for improving voice function in patients with vocal fold paralysis, compared with framework surgery.

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