Perspectives on voice treatment for unilateral vocal fold paralysis

Walton, Chloe; Carding, Paul; Flanagan, Kieran

doi:10.1097/moo.0000000000000450

Cited by 35 publications

(33 citation statements)

References 53 publications

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“…The assessments of treatment outcomes differ markedly [ 34 , 35 ]. Studies dealing with comparisons between various therapies also have not used consistent indicators [ 33 , 35 , 36 ]. This makes it difficult to communicate about the results of research in this field, to make direct comparisons between studies, and to perform meta-analyses; however, this issue may be partially resolved by using a primary set of parameters.…”

Section: Guidelines For the Management Of Uvfpmentioning

confidence: 99%

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Force

2020

Clin Exp Otorhinolaryngol

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The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.

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Section: Guidelines For the Management Of Uvfpmentioning

confidence: 99%

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Force

2020

Clin Exp Otorhinolaryngol

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“…Thus, it is important to appropriately address treatment options. Surgical options can be frequently categorized into medialization versus reinnervation options 13–14 . Medialization techniques were used in this patient and included a temporary Restalyn injection shortly after surgery followed later by operative medialization with an implant.…”

Section: Discussionmentioning

confidence: 99%

“…Vocal fold paralysis often causes dysphonia but can also have additional severe impact on quality of life and has been correlated with loss of income and reduced socialization. 13 Thus, it is important to appropriately address treatment options. Surgical options can be frequently categorized into medialization versus reinnervation options.…”

Section: Discussionmentioning

confidence: 99%

Paraganglioma of the recurrent laryngeal nerve

et al. 2019

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Paragangliomas of the head and neck are rare, and most frequently benign, slow growing, and nonsecretory. The most frequent locations these tumors arise in the head and neck include the carotid body, jugular bulb, vagus nerve, tympanic branch of the glossopharyngeal nerve, and sympathetic chain. Here we present, to our knowledge, the second reported case of paraganglioma of the recurrent laryngeal nerve. This case is unique given the patient presentation due to ipsilateral vocal fold paralysis, which has not previously been reported, lack of previous surgery, and demonstration of loss of succinate dehydrogenase iron-sulfur subunit B expression.

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“…Therapy is sometimes used preoperatively to minimize laryngeal hyperfunction and help improve voice outcomes postoperatively, despite a lack of evidence regarding the combined voice therapy and surgical approach to glottic insufficiency. [21][22][23] This study provides some evidence that this approach may not be necessary, although it is recognized that a lack of consistency in content, frequency, and type of voice therapy in treatment of glottic insufficiency renders comparison among treatment combinations difficult.…”

Section: Discussionmentioning

confidence: 99%

Multi‐institutional Evaluation of Medialization Laryngoplasty in the Elderly

Philips

Chorath

deSilva

et al. 2018

Otolaryngol.--head neck surg.

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Objective To evaluate voice outcomes of medialization laryngoplasty in the elderly population (65 years and older) and to identify swallow outcomes, complication rates, and predictors of voice outcomes. Study Design Case series with chart review. Setting Two tertiary academic medical centers. Subjects and Methods We retrospectively reviewed charts of 136 patients age 65 years and older undergoing medialization laryngoplasty between January 2008 and May 2016 at 2 tertiary academic institutions. Primary outcome was assessed using Voice Handicap Index 10 (VHI-10) score and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) score. Secondary outcomes were assessed using the Eating Assessment Tool 10 (EAT-10) when dysphagia was present, stroboscopic analysis of glottic closure, and complication rates. A logistic regression analysis assessed predictors of voice improvement after medialization laryngoplasty. Results Total GRBAS and VHI-10 scores showed a significant improvement postoperatively (P < .05). A ≥20% improvement was seen in 81.6% of patients, and a ≥50% improvement was seen in 53.7%. No patient had major complications. Minor complications occurred in 5.9% of patients. Multivariable logistic regression identified preoperative injection augmentation as an independent predictor of less improvement in VHI-10 score (P = .015). Voice therapy prior to medialization did not affect voice outcomes (P = .640). Conclusion Patient- and provider-perceived voice quality are significantly improved after medialization laryngoplasty in the elderly, and the procedure is associated with a low complication rate even in an elderly cohort. Improvement in patient-perceived voice outcomes after medialization laryngoplasty was diminished in patients with preoperative injection augmentation.

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Perspectives on voice treatment for unilateral vocal fold paralysis

Abstract: Further consensus is required for the rationale and selection of voice treatment prescriptions for the management of UVFP in order to improve treatment effectiveness and voice outcomes in patients with UVFP.

Cited by 35 publications

References 53 publications

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Paraganglioma of the recurrent laryngeal nerve

Multi‐institutional Evaluation of Medialization Laryngoplasty in the Elderly

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