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Glottal gap as an early predictor for permanent laryngoplasty in unilateral vocal fold paralysis.
Laryngoscope. 2014 Sep; 124(9):2125-30.L

Abstract

OBJECTIVES/HYPOTHESIS

To assess the possible predictive factors for permanent laryngoplasty (PL) in patients with acute unilateral vocal fold paralysis (UVFP), and to assess the effects of early vocal cord hyaluronic acid injection.

STUDY DESIGN

Prospective cohort study.

METHODS

Patients diagnosed with UVFP within the previous 6 months were enrolled. Initial and follow-up videolaryngostroboscopy, voice laboratory analysis, laryngeal electromyography, and Voice Outcome Survey were performed.

RESULTS

Fifty newly diagnosed UVFP patients were recruited. Eight were excluded after 12 months of follow-up and data for 42 patients were analyzed. In patients treated conservatively, the glottal gap was measured on presentation. Normalized glottal gap area (NGGA) was the only predictor of PL (P = 0.036) according to multivariate logistic regression analysis. A cutoff value of 7.36 resulted in sensitivity of 85.7% and specificity of 80.0% for predicting future PL. The PL rate was significantly higher in patients with an initial NGGA > 7.36 compared with ≤ 7.36. (6/9 vs. 1/13; χ(2) = 6.71; P = 0.010). Among patients with an initial NGGA > 7.36, those who accepted early hyaluronic acid injection had a significantly lower rate of PL (1/11 vs. 6/9; χ(2) = 7.21; P = 0.007) and better social and emotional role functioning at follow-up.

CONCLUSIONS

The glottal gap on presentation is a robust early predictor of PL. Early, office-based hyaluronic acid intracordal injection can reduce the need for PL in patients with a large NGGA.

Authors+Show Affiliations

Department of Otolaryngology, Chang Gung Memorial Hospital at Taipei, Taipei.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24668456

Citation

Fang, Tuan-Jen, et al. "Glottal Gap as an Early Predictor for Permanent Laryngoplasty in Unilateral Vocal Fold Paralysis." The Laryngoscope, vol. 124, no. 9, 2014, pp. 2125-30.
Fang TJ, Pei YC, Li HY, et al. Glottal gap as an early predictor for permanent laryngoplasty in unilateral vocal fold paralysis. Laryngoscope. 2014;124(9):2125-30.
Fang, T. J., Pei, Y. C., Li, H. Y., Wong, A. M., & Chiang, H. C. (2014). Glottal gap as an early predictor for permanent laryngoplasty in unilateral vocal fold paralysis. The Laryngoscope, 124(9), 2125-30. https://doi.org/10.1002/lary.24689
Fang TJ, et al. Glottal Gap as an Early Predictor for Permanent Laryngoplasty in Unilateral Vocal Fold Paralysis. Laryngoscope. 2014;124(9):2125-30. PubMed PMID: 24668456.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glottal gap as an early predictor for permanent laryngoplasty in unilateral vocal fold paralysis. AU - Fang,Tuan-Jen, AU - Pei,Yu-Cheng, AU - Li,Hsueh-Yu, AU - Wong,Alice M K, AU - Chiang,Hui-Chen, Y1 - 2014/05/27/ PY - 2014/01/19/received PY - 2014/03/03/revised PY - 2014/03/24/accepted PY - 2014/3/27/entrez PY - 2014/3/29/pubmed PY - 2014/10/21/medline KW - Unilateral vocal fold paralysis KW - Voice Outcome Survey KW - glottal gap KW - hyaluronic acid KW - injection laryngoplasty SP - 2125 EP - 30 JF - The Laryngoscope JO - Laryngoscope VL - 124 IS - 9 N2 - OBJECTIVES/HYPOTHESIS: To assess the possible predictive factors for permanent laryngoplasty (PL) in patients with acute unilateral vocal fold paralysis (UVFP), and to assess the effects of early vocal cord hyaluronic acid injection. STUDY DESIGN: Prospective cohort study. METHODS: Patients diagnosed with UVFP within the previous 6 months were enrolled. Initial and follow-up videolaryngostroboscopy, voice laboratory analysis, laryngeal electromyography, and Voice Outcome Survey were performed. RESULTS: Fifty newly diagnosed UVFP patients were recruited. Eight were excluded after 12 months of follow-up and data for 42 patients were analyzed. In patients treated conservatively, the glottal gap was measured on presentation. Normalized glottal gap area (NGGA) was the only predictor of PL (P = 0.036) according to multivariate logistic regression analysis. A cutoff value of 7.36 resulted in sensitivity of 85.7% and specificity of 80.0% for predicting future PL. The PL rate was significantly higher in patients with an initial NGGA > 7.36 compared with ≤ 7.36. (6/9 vs. 1/13; χ(2) = 6.71; P = 0.010). Among patients with an initial NGGA > 7.36, those who accepted early hyaluronic acid injection had a significantly lower rate of PL (1/11 vs. 6/9; χ(2) = 7.21; P = 0.007) and better social and emotional role functioning at follow-up. CONCLUSIONS: The glottal gap on presentation is a robust early predictor of PL. Early, office-based hyaluronic acid intracordal injection can reduce the need for PL in patients with a large NGGA. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/24668456/Glottal_gap_as_an_early_predictor_for_permanent_laryngoplasty_in_unilateral_vocal_fold_paralysis_ L2 - https://doi.org/10.1002/lary.24689 DB - PRIME DP - Unbound Medicine ER -