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Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis.
Laryngoscope. 2017 07; 127(7):1628-1632.L

Abstract

OBJECTIVES/HYPOTHESIS

Intralaryngeal muscle synkinesis associated with unilateral vocal fold paralysis (UVFP) is thought to preserve thyroarytenoid-lateral cricoarytenoid muscle complex tone, resulting in a better voice despite the presence of vocal fold paralysis (VFP). This study compares voice handicap in patients with unilateral VFP (UVFP) with and without evidence of adductory synkinesis on laryngeal electromyography (LEMG).

STUDY DESIGN

Retrospective review of LEMG data and Voice Handicap Index-10 (VHI-10) scores of patients diagnosed with permanent UVFP.

METHODS

LEMG was performed within 1 to 6 months post onset of UVFP. Patients were stratified into two groups: 1) recurrent laryngeal nerve (RLN) neuropathy with synkinesis and 2) RLN neuropathy without synkinesis. Synkinesis was diagnosed when the sniff to phonation maximum amplitude ratio was ≥0.65. VHI-10 scores at 6-month follow-up were recorded.

RESULTS

Four hundred forty-nine patients with UVFP and who had an LEMG were reviewed. Eighty-three patients met the inclusion criteria, with 16 in group 1 and 67 in group 2. There was no significant difference between the groups with regard to age, timing of LEMG from onset of VFP, number of patients undergoing temporary vocal fold injection or use of off-label nimodipine. Average VHI-10 scores at 6 months post onset of VFP were 14.4 ± 10.6 for patients with LEMG-identified synkinesis (group 1) and 21.0 ± 10.1 for patients with no LEMG evidence of synkinesis (group 2). This was statistically significant (P = .02).

CONCLUSIONS

Patients with unilateral vocal fold paralysis and LEMG evidence of laryngeal synkinesis are more likely to have less perceived voice handicap than those without synkinesis.

LEVEL OF EVIDENCE

4. Laryngoscope, 127:1628-1632, 2017.

Authors+Show Affiliations

University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A. Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.University of Pittsburgh Voice Center, Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28105659

Citation

Lin, R Jun, et al. "Effect of Intralaryngeal Muscle Synkinesis On Perception of Voice Handicap in Patients With Unilateral Vocal Fold Paralysis." The Laryngoscope, vol. 127, no. 7, 2017, pp. 1628-1632.
Lin RJ, Munin MC, Rosen CA, et al. Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis. Laryngoscope. 2017;127(7):1628-1632.
Lin, R. J., Munin, M. C., Rosen, C. A., & Smith, L. J. (2017). Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis. The Laryngoscope, 127(7), 1628-1632. https://doi.org/10.1002/lary.26390
Lin RJ, et al. Effect of Intralaryngeal Muscle Synkinesis On Perception of Voice Handicap in Patients With Unilateral Vocal Fold Paralysis. Laryngoscope. 2017;127(7):1628-1632. PubMed PMID: 28105659.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of intralaryngeal muscle synkinesis on perception of voice handicap in patients with unilateral vocal fold paralysis. AU - Lin,R Jun, AU - Munin,Michael C, AU - Rosen,Clark A, AU - Smith,Libby J, Y1 - 2017/01/20/ PY - 2016/05/01/received PY - 2016/09/12/revised PY - 2016/09/27/accepted PY - 2017/1/21/pubmed PY - 2017/8/19/medline PY - 2017/1/21/entrez KW - LEMG KW - Voice KW - dysphonia KW - laryngeal electromyophgray KW - vocal cord paralysis KW - vocal fold paralysis KW - voice handicap KW - voice outcome SP - 1628 EP - 1632 JF - The Laryngoscope JO - Laryngoscope VL - 127 IS - 7 N2 - OBJECTIVES/HYPOTHESIS: Intralaryngeal muscle synkinesis associated with unilateral vocal fold paralysis (UVFP) is thought to preserve thyroarytenoid-lateral cricoarytenoid muscle complex tone, resulting in a better voice despite the presence of vocal fold paralysis (VFP). This study compares voice handicap in patients with unilateral VFP (UVFP) with and without evidence of adductory synkinesis on laryngeal electromyography (LEMG). STUDY DESIGN: Retrospective review of LEMG data and Voice Handicap Index-10 (VHI-10) scores of patients diagnosed with permanent UVFP. METHODS: LEMG was performed within 1 to 6 months post onset of UVFP. Patients were stratified into two groups: 1) recurrent laryngeal nerve (RLN) neuropathy with synkinesis and 2) RLN neuropathy without synkinesis. Synkinesis was diagnosed when the sniff to phonation maximum amplitude ratio was ≥0.65. VHI-10 scores at 6-month follow-up were recorded. RESULTS: Four hundred forty-nine patients with UVFP and who had an LEMG were reviewed. Eighty-three patients met the inclusion criteria, with 16 in group 1 and 67 in group 2. There was no significant difference between the groups with regard to age, timing of LEMG from onset of VFP, number of patients undergoing temporary vocal fold injection or use of off-label nimodipine. Average VHI-10 scores at 6 months post onset of VFP were 14.4 ± 10.6 for patients with LEMG-identified synkinesis (group 1) and 21.0 ± 10.1 for patients with no LEMG evidence of synkinesis (group 2). This was statistically significant (P = .02). CONCLUSIONS: Patients with unilateral vocal fold paralysis and LEMG evidence of laryngeal synkinesis are more likely to have less perceived voice handicap than those without synkinesis. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1628-1632, 2017. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/28105659/Effect_of_intralaryngeal_muscle_synkinesis_on_perception_of_voice_handicap_in_patients_with_unilateral_vocal_fold_paralysis_ L2 - https://doi.org/10.1002/lary.26390 DB - PRIME DP - Unbound Medicine ER -