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Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice.
J Voice. 2009 May; 23(3):396-8.JV

Abstract

A retrospective chart review was performed at the senior author's voice disorder clinic to report the symptoms, signs, and laryngeal electromyography (LEMG) data of patients presenting with vocal fold paresis (VFP) in a tertiary laryngology academic practice over a 4-year period. Medical records of 739 patients presenting to the clinic with a chief complaint of dysphonia (for 2000-2004) were assessed. History intake forms, strobovideolaryngoscopy images, and LEMG reports were reviewed for all patients with a clinical diagnosis of VFP. Of the 739 patients presenting to the clinic with voice complaints, 195 were initially diagnosed with either vocal fold paralysis or VFP (26.4%). Only 13 out of 739 patients (1.8%) with voice complaints were diagnosed with LEMG-confirmed unilateral or bilateral VFP. The most common findings on strobovideolaryngoscopy were vocal fold bowing (70%), incomplete closure (62%), and increased vibratory amplitude (38%). Seventy percentage of the patients had unilateral VFP, predominantly isolated recurrent laryngeal nerve (RLN) disease. Only 9% had unilateral superior laryngeal nerve (SLN) involvement. The most common LEMG abnormality was reduced recruitment of motor units. In our voice center, VFP was a relatively uncommon diagnostic entity. Despite the low prevalence, VFP needs to be considered in all patients who present with dysphonia. Further study is needed to examine the prevalence of "abnormal" LEMG studies in an asymptomatic control population, and to determine the utility of LEMG in the evaluation and management of dysphonia. In the same way that strobovideolaryngoscopy has been critically evaluated in the past, there is also a need to determine how commonly LEMG contributes essential data which leads to a change in the patient's management and/or ultimate vocal outcome.

Authors+Show Affiliations

Department of Otolaryngology, University of Texas Health Science Center, San Antonio, TX 78229-3900, USA. simpsonc@uthscsa.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18329845

Citation

Simpson, C Blake, et al. "Vocal Fold Paresis: Clinical and Electrophysiologic Features in a Tertiary Laryngology Practice." Journal of Voice : Official Journal of the Voice Foundation, vol. 23, no. 3, 2009, pp. 396-8.
Simpson CB, Cheung EJ, Jackson CJ. Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice. J Voice. 2009;23(3):396-8.
Simpson, C. B., Cheung, E. J., & Jackson, C. J. (2009). Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice. Journal of Voice : Official Journal of the Voice Foundation, 23(3), 396-8. https://doi.org/10.1016/j.jvoice.2007.10.011
Simpson CB, Cheung EJ, Jackson CJ. Vocal Fold Paresis: Clinical and Electrophysiologic Features in a Tertiary Laryngology Practice. J Voice. 2009;23(3):396-8. PubMed PMID: 18329845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice. AU - Simpson,C Blake, AU - Cheung,Esther J, AU - Jackson,Carlayne J, Y1 - 2008/03/10/ PY - 2006/05/03/received PY - 2007/10/12/accepted PY - 2008/3/11/pubmed PY - 2009/7/17/medline PY - 2008/3/11/entrez SP - 396 EP - 8 JF - Journal of voice : official journal of the Voice Foundation JO - J Voice VL - 23 IS - 3 N2 - A retrospective chart review was performed at the senior author's voice disorder clinic to report the symptoms, signs, and laryngeal electromyography (LEMG) data of patients presenting with vocal fold paresis (VFP) in a tertiary laryngology academic practice over a 4-year period. Medical records of 739 patients presenting to the clinic with a chief complaint of dysphonia (for 2000-2004) were assessed. History intake forms, strobovideolaryngoscopy images, and LEMG reports were reviewed for all patients with a clinical diagnosis of VFP. Of the 739 patients presenting to the clinic with voice complaints, 195 were initially diagnosed with either vocal fold paralysis or VFP (26.4%). Only 13 out of 739 patients (1.8%) with voice complaints were diagnosed with LEMG-confirmed unilateral or bilateral VFP. The most common findings on strobovideolaryngoscopy were vocal fold bowing (70%), incomplete closure (62%), and increased vibratory amplitude (38%). Seventy percentage of the patients had unilateral VFP, predominantly isolated recurrent laryngeal nerve (RLN) disease. Only 9% had unilateral superior laryngeal nerve (SLN) involvement. The most common LEMG abnormality was reduced recruitment of motor units. In our voice center, VFP was a relatively uncommon diagnostic entity. Despite the low prevalence, VFP needs to be considered in all patients who present with dysphonia. Further study is needed to examine the prevalence of "abnormal" LEMG studies in an asymptomatic control population, and to determine the utility of LEMG in the evaluation and management of dysphonia. In the same way that strobovideolaryngoscopy has been critically evaluated in the past, there is also a need to determine how commonly LEMG contributes essential data which leads to a change in the patient's management and/or ultimate vocal outcome. SN - 1873-4588 UR - https://www.unboundmedicine.com/medline/citation/18329845/Vocal_fold_paresis:_clinical_and_electrophysiologic_features_in_a_tertiary_laryngology_practice_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0892-1997(07)00140-3 DB - PRIME DP - Unbound Medicine ER -