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Disease Characteristics and Electromyographic Findings of Nonsurgery-Related Unilateral Vocal Fold Paralysis.
Laryngoscope. 2017 06; 127(6):1381-1387.L

Abstract

OBJECTIVE

The detailed characteristics and prognosis of nonsurgery-related unilateral vocal fold paralysis (NSUVFP) are currently unclear. This study evaluated the extent of laryngeal nerve lesions and the individual characteristics for patients with NSUVFP.

STUDY DESIGN

Retrospective, case series.

METHODS

Patients with unilateral vocal fold paralysis (UVFP) were evaluated using videolaryngostroboscopy and quantitative laryngeal electromyography. The side of nerve lesions, involvement of the external branch of the superior laryngeal nerve (eSLN), and complete vocal fold motion recovery were evaluated after ≥ 6 month follow-up.

RESULTS

A total of 207 UVFP patients were recruited, including 153 surgery-related UVFP and 54 NSUVFP patients. Thirty-four (63%) and 20 (37%) NSUVFP patients were further assigned to idiopathic and nonsurgery-related-nonidiopathic (NSNI) groups, respectively. In the idiopathic group, eSLN lesions occurred in all six (100%) patients with right-side paralysis, but in only six of 28 (21%) patients with left-side paralysis (P < 0.001). The turn frequency of the paralyzed thyroarytenoid-lateral cricoarytenoid muscle complex is lower in the NSNI group (333.1 ± 192.1) compared with the idiopathic group (490.2 ± 255.1) (P = 0.02). The probability of complete vocal fold motion recovery did not differ among groups (P > 0.05).

CONCLUSION

Idiopathic and NSNI UVFP have different clinical presentations defined by laryngeal electromyography. NSNI UVFP had more severe denervation changes compared with idiopathic UVFP. These results may support two pathogenic mechanisms for idiopathic UVFP: 1) neuropathy specifically involving left recurrent laryngeal nerve (RLN), and 2) neuropathy affecting nerves proximal to the RLN.

LEVEL OF EVIDENCE

4. Laryngoscope, 127:1381-1387, 2017.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. School of Medicine, Chang Gung University, Taoyuan, Taiwan. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. School of Medicine, Chang Gung University, Taoyuan, Taiwan.Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. School of Medicine, Chang Gung University, Taoyuan, Taiwan.

Pub Type(s)

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

Language

eng

PubMed ID

27666943

Citation

Pei, Yu-Cheng, et al. "Disease Characteristics and Electromyographic Findings of Nonsurgery-Related Unilateral Vocal Fold Paralysis." The Laryngoscope, vol. 127, no. 6, 2017, pp. 1381-1387.
Pei YC, Li HY, Chen CL, et al. Disease Characteristics and Electromyographic Findings of Nonsurgery-Related Unilateral Vocal Fold Paralysis. Laryngoscope. 2017;127(6):1381-1387.
Pei, Y. C., Li, H. Y., Chen, C. L., Wong, A. M. K., Huang, P. C., & Fang, T. J. (2017). Disease Characteristics and Electromyographic Findings of Nonsurgery-Related Unilateral Vocal Fold Paralysis. The Laryngoscope, 127(6), 1381-1387. https://doi.org/10.1002/lary.26329
Pei YC, et al. Disease Characteristics and Electromyographic Findings of Nonsurgery-Related Unilateral Vocal Fold Paralysis. Laryngoscope. 2017;127(6):1381-1387. PubMed PMID: 27666943.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disease Characteristics and Electromyographic Findings of Nonsurgery-Related Unilateral Vocal Fold Paralysis. AU - Pei,Yu-Cheng, AU - Li,Hsueh-Yu, AU - Chen,Cheng-Lun, AU - Wong,Alice M K, AU - Huang,Pei-Chi, AU - Fang,Tuan-Jen, Y1 - 2016/09/26/ PY - 2016/08/19/accepted PY - 2016/9/27/pubmed PY - 2017/8/19/medline PY - 2016/9/27/entrez KW - Vocal cord palsy KW - laryngeal electromyography KW - quantitative electromyography KW - superior laryngeal nerve KW - videolaryngostroboscopy SP - 1381 EP - 1387 JF - The Laryngoscope JO - Laryngoscope VL - 127 IS - 6 N2 - OBJECTIVE: The detailed characteristics and prognosis of nonsurgery-related unilateral vocal fold paralysis (NSUVFP) are currently unclear. This study evaluated the extent of laryngeal nerve lesions and the individual characteristics for patients with NSUVFP. STUDY DESIGN: Retrospective, case series. METHODS: Patients with unilateral vocal fold paralysis (UVFP) were evaluated using videolaryngostroboscopy and quantitative laryngeal electromyography. The side of nerve lesions, involvement of the external branch of the superior laryngeal nerve (eSLN), and complete vocal fold motion recovery were evaluated after ≥ 6 month follow-up. RESULTS: A total of 207 UVFP patients were recruited, including 153 surgery-related UVFP and 54 NSUVFP patients. Thirty-four (63%) and 20 (37%) NSUVFP patients were further assigned to idiopathic and nonsurgery-related-nonidiopathic (NSNI) groups, respectively. In the idiopathic group, eSLN lesions occurred in all six (100%) patients with right-side paralysis, but in only six of 28 (21%) patients with left-side paralysis (P < 0.001). The turn frequency of the paralyzed thyroarytenoid-lateral cricoarytenoid muscle complex is lower in the NSNI group (333.1 ± 192.1) compared with the idiopathic group (490.2 ± 255.1) (P = 0.02). The probability of complete vocal fold motion recovery did not differ among groups (P > 0.05). CONCLUSION: Idiopathic and NSNI UVFP have different clinical presentations defined by laryngeal electromyography. NSNI UVFP had more severe denervation changes compared with idiopathic UVFP. These results may support two pathogenic mechanisms for idiopathic UVFP: 1) neuropathy specifically involving left recurrent laryngeal nerve (RLN), and 2) neuropathy affecting nerves proximal to the RLN. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1381-1387, 2017. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/27666943/Disease_Characteristics_and_Electromyographic_Findings_of_Nonsurgery_Related_Unilateral_Vocal_Fold_Paralysis_ L2 - https://doi.org/10.1002/lary.26329 DB - PRIME DP - Unbound Medicine ER -