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Unilateral vocal fold paralysis: can laryngoscopy predict recovery? A prospective study

Published online by Cambridge University Press:  17 November 2014

J K R Menon ,
R M Nair  and
S Priyanka
J K R Menon
Affiliation:
Department of Laryngology, Kerala Institute of Medical Sciences Hospital, Thiruvananthapuram, India
R M Nair*
Affiliation:
Department of ENT, PVS Memorial Hospital, Kochi, Kerala, India
S Priyanka
Affiliation:
Unit of Speech Language Pathology and Audiology, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
*
Address for correspondence: Dr Reshmi M Nair, Sreeshailam, Cherupillil Road, Azad Road, Kaloor, Kochi, Kerala 682017, India E-mail: drreshmient@gmail.com
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Abstract

Objective:

To determine the prognostic value of laryngoscopy in predicting the recovery of unilateral vocal fold paralysis.

Method:

A prospective study was carried out of all patients with unilateral vocal fold paralysis without a progressive lesion or arytenoid dislocation.

Results:

Among the 66 candidates, 15 recovered. Patients with interarytenoid paralysis (p < 0.001) or posterolateral tilt of the arytenoid (p = 0.028) had less chance of recovery. Among 51 patients who did not recover, 25.49 per cent regained phonatory function by compensatory movement of the normal side; the rest required an intervention. Intervention requirement was significantly less for those patients who had isolated glottic level compensation. The paralysed vocal fold was at the same level in 32.35 per cent of patients, higher in 38.23 per cent and lower in 29.42 per cent. In those in whom vocal folds were in the abducted position (46.67 per cent), the affected vocal fold was at a lower position on phonation. Inter-observer reliability assessment revealed excellent to good agreement for all criteria.

Conclusion:

Interarytenoid paralysis and posterolateral tilt of the arytenoid were predictors of poor recovery.

Keywords

Vocal Fold PalsyVocal Cord ParalysisLaryngoscopyArytenoid Muscle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 12 , December 2014 , pp. 1095 - 1104
Copyright
Copyright © JLO (1984) Limited 2014 

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Footnotes

Presented as a poster at the Cutting Edge Laryngology 2013 conference, 18 June 2013, London, UK.

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