Etiology and Time to Presentation of Unilateral Vocal Fold Paralysis

Spataro, Emily A.; Grindler, David J.; Paniello, Randal C.

doi:10.1177/0194599814531733

Cited by 73 publications

(87 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, those with idiopathic and other etiologies were more often managed with supportive care and avoided definitive surgery. Etiologies encountered in this study coincide with those described in large case series in the literature . Similarly, the laterality propensity based on etiology corresponds closely with that described in a recent study .…”

Section: Discussionsupporting

confidence: 88%

“…Skew is zero when there is no laterality predilection. However, as ratio of left‐sided cases increases, the value becomes more negative, with a maximum/minimum value of ± 0.5 . Skewness was measured and plotted for each UVFP etiology that had greater than five cases in the cohort and statistical significance assessed using Pearson's or Fisher's exact chi 2 tests, as appropriate.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis

et al. 2015

View full text Add to dashboard Cite

Objective To determine whether injection augmentation reduces the likelihood of ultimately needing definitive framework surgery in unilateral vocal fold paralysis (UVFP) patients. Study Design Retrospective cohort study Methods All patients diagnosed with UVFP (2008–2012) at the academic center were identified. Time from symptom onset to presentation to either a community otolaryngologist and/or academic center as well as any directed treatment(s) were recorded. Stepwise, multivariate logistic regression analysis was used to determine whether injection augmentation independently affected odds of needing definitive, framework surgery among patients seen within nine months of symptom onset and who had not undergone any prior rehabilitative procedures. Results Cohort consisted of 633 patients (55% female, 80% Caucasian, median age 60 years) with UVFP. The majority of etiologies were either surgery (48%) or idiopathic (37%). Duration to presentation at community otolaryngologist was shorter than to the academic center (median 2 vs. 6 months). Overall, less than half of UVFP patients had any operation (46%). Multivariate logistic regression found that earlier injection augmentation did not affect odds of ultimately undergoing framework surgery (OR 1.13, CI 0.92 – 1.40; p=0.23). Conclusion Nearly half of UVFP patients do not require any rehabilitative procedure. When indicated, early injection augmentation is effective at temporarily alleviating associated symptoms, but does not reduce likelihood of needing a definitive framework operation in patients with UVFP. Understanding practice patterns and fostering early detection and treatment may improve quality of life in this patient population.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…While malignancy is responsible for 17.8%-18.4% of UVCPs, direct invasion of thyroid cancer is responsible for 1.5%. Of all UVCPs, 5.8%-6.2% are due to intubation, 3.2%-6.1% are due to trauma, and 13.2%-18.5% are idiopathic (7,8). In this case, there was no nerve injury causing VCP; however, a hematoma caused during intubation resulted in VCP.…”

Section: Discussionmentioning

confidence: 75%

A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma

et al. 2017

View full text Add to dashboard Cite

A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma Although vocal cord paralysis (VCP) following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis following thyroidectomy can be caused by a vocal cord hematoma with an incidence of 1.4% due to direct injury during orotracheal intubation. In this article, we present a case of VCP caused by vocal cord hematoma. A 32-year-old male patient who has been receiving propylthiouracil treatment for toxic multinodular goiter since 10 years was admitted to our hospital to be operated because of persisting complaints. The patient was hospitalized for sutureless thyroidectomy after he became euthyroid. Preoperative fiberoptic laryngoscopy performed by the ear, nose, and throat department revealed bilaterally motile vocal folds and a completely open airway. Patient underwent sutureless total thyroidectomy with a vessel sealing device (Ligasure TM LF1212, Covidien, CO), and a minivac drainage system was placed in the thyroid lodge. On the morning of the first postoperative day, 50 mL of serosanguinous fluid was drained. The patient's voice was normal, and there was no ecchymosis. Postoperative fiberoptic laryngoscopy revealed a hematoma near the right vocal fold and paralysis of the right vocal fold; however, the airway was open. It should be kept in mind that VCP is not solely due to surgery but can also result from intubation, as observed in this case. Keywords: Vocal cord hematoma, vocal cord paralysis, hematoma, thyroidectomy INTRODUCTIONThyroid surgery is one of the most popular surgeries worldwide. Postoperative hematoma after total thyroidectomy is a major but unpredictable complication. However, it can be diagnosed by follow-up after surgery even in unsuspected cases. Although it is generally asymptomatic, patients with postoperative hematoma can suffer from a range of symptoms from ecchymosis to life-threating dyspnea (1, 2).Vocal cord paralysis (VCP) following thyroidectomy is another major complication, and its incidence has been varied (1, 2). Although VCP following thyroidectomy is primarily associated with surgical trauma, it is not the sole etiology. Vocal cord paralysis can result from nerve damage, such as transection (complete or partial), excessive traction, direct handling, contusion, crush, thermal injury, clamping, incorrect ligature, and compromised blood supply. In addition, neurological diseases, tuberculosis, aortic aneurysms, lung and mediastinal malignancies, esophageal malignancies, metastatic tumors, and post-anesthesia complications can cause VCP (1, 2). According to a review by Jeannon et al. (3) that includes 27 articles and evaluates over 25,000 patients, the average rate of temporary VCP is 9.8% (1.4%-38.4%), whereas the average rate of permanent VCP is 2.3% (0%-18.6%). Vocal cord paralysis following thyroidectomy can result from a vocal cord hematoma with an incidence of 1.4%, due to direct injury during orotracheal intubation (incidence: 4.5%)(4, 5). In this articl...

show abstract

“…It commonly manifests with swallowing disability, shortness of breath, and hoarseness (1). The most common etiologies of UVFP include iatrogenic injuries, malignancies with invasion to the vagus nerve or recurrent laryngeal nerve, blunt trauma, and iatrogenic phenomena (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Our Experience of Medialization Thyroplasty with Freeze-Dried Cadaveric Human Fascia Lata in Unilateral True Vocal Cord Paralysis

Izadi¹,

Rasoolpanah²,

Maleki³

et al. 2017

Trauma Mon

View full text Add to dashboard Cite

Background: Use of autologous fascia, harvested from the thigh fascia lata, has been shown to be effective in the treatment of unilateral vocal fold paralysis (UVFP). However, advantages of this material have been less examined in the clinical setting. The present study aimed to assess the beneficial effects of medialization thyroplasty type I with cadaveric fascia lata on the vocal function of patients with UVFP.

show abstract

Etiology and Time to Presentation of Unilateral Vocal Fold Paralysis

Abstract: Iatrogenic injury remains the most common cause of UVFP. Thyroidectomy remains the leading cause of surgery-related UVFP. Patients are typically seen within 3-4 months of onset; however, a significant delay exists for those referred to WUSM.

Cited by 73 publications

References 29 publications

Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis

Effect of injection augmentation on need for framework surgery in unilateral vocal fold paralysis

A rare case of non-surgical vocal cord paralysis: Vocal cord hematoma

Our Experience of Medialization Thyroplasty with Freeze-Dried Cadaveric Human Fascia Lata in Unilateral True Vocal Cord Paralysis

Contact Info

Product

Resources

About