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Vocal fold paresis – a debilitating and underdiagnosed condition

Published online by Cambridge University Press:  02 May 2017

G Harris ,
C O'Meara ,
C Pemberton ,
J Rough ,
P Darveniza ,
S Tisch  and
I Cole
G Harris*
Affiliation:
Voice Assessment Centre, Department of Otolaryngology, St Vincent's Clinic, Darlinghurst, Sydney, Australia
C O'Meara
Affiliation:
Voice Assessment Centre, Department of Otolaryngology, St Vincent's Clinic, Darlinghurst, Sydney, Australia
C Pemberton
Affiliation:
Voice Assessment Centre, Department of Otolaryngology, St Vincent's Clinic, Darlinghurst, Sydney, Australia
J Rough
Affiliation:
Department of Speech Pathology, St Vincent's Hospital, Darlinghurst, Sydney, Australia
P Darveniza
Affiliation:
Department of Neurology, St Vincent's Hospital, Darlinghurst, Sydney, Australia
S Tisch
Affiliation:
Department of Neurology, St Vincent's Hospital, Darlinghurst, Sydney, Australia
I Cole
Affiliation:
Voice Assessment Centre, Department of Otolaryngology, St Vincent's Clinic, Darlinghurst, Sydney, Australia
*
Address for correspondence: Dr Georgina Harris, PO BOX 4024, Royal North Shore Hospital, NSW 2065, Australia E-mail: drgeorginaharris@gmail.com
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Abstract

Objectives:

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.

Keywords

DysphoniaVocal Cord ParesisVHI-10Laryngeal Electromyography
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Supplement S2: ASOHNS Supplement , July 2017 , pp. S48 - S52
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Meeting, 7–10 March 2015, Sydney, and at the 2nd Australasian and Asia Pacific Laryngology Conference, 7–9 November 2014, Hobart, Australia.

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