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Implications of Synkinesis in Unilateral Vocal Fold Paralysis.
Otolaryngol Head Neck Surg. 2017 12; 157(6):1017-1024.OH

Abstract

Objectives In patients with unilateral vocal fold paralysis (UVFP), laryngeal electromyography (LEMG) occasionally observes synkinesis in laryngeal muscles, a condition that could impair vocal fold mobility and voice control. This study aims to evaluate the impact of synkinesis on UVFP patients. Study Design A retrospective case-control study. Setting Medical center. Subjects and Methods Patients with UVFP onset >6 months were recruited (N = 104). The outcome measurements included LEMG, quantitative LEMG analysis of thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex, glottal gap measured by videolaryngostroboscopy, voice-related quality of life, and voice acoustic analysis. Results According to the LEMG analysis, 8 patients (8%) had synkinesis, and 96 (92%) did not. In the synkinesis group, TA-LCA turn frequency in the lesioned side was comparable to that in the healthy side (P = .52). Patients in the synkinesis group had higher TA-LCA turn frequency (P = .001), higher probability of cricothyroid muscle dysfunction (P = .04), and better voice-related quality of life (P = .01) but objective voice outcomes comparable to those in the nonsynkinesis group. Conclusions Patients with synkinesis will have near-complete restoration in TA-LCA turn frequency but still experience voice impairment, a finding that is compatible with the mechanism of aberrant reinnervation. However, patients with synkinesis have better disease-related quality of life than do those without synkinesis.

Authors+Show Affiliations

1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. 2 Center of Vascularized Tissue Allograft, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. 3 Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. 4 School of Medicine, Chang Gung University, Taoyuan, Taiwan.1 Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. 4 School of Medicine, Chang Gung University, Taoyuan, Taiwan. 5 Institute of Biomedical Engineering, National Taiwan University, Taiwan.6 Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.6 Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.4 School of Medicine, Chang Gung University, Taoyuan, Taiwan. 6 Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.

Pub Type(s)

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

Language

eng

PubMed ID

28762290

Citation

Pei, Yu-Cheng, et al. "Implications of Synkinesis in Unilateral Vocal Fold Paralysis." Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 157, no. 6, 2017, pp. 1017-1024.
Pei YC, Chang WH, Chuang HF, et al. Implications of Synkinesis in Unilateral Vocal Fold Paralysis. Otolaryngol Head Neck Surg. 2017;157(6):1017-1024.
Pei, Y. C., Chang, W. H., Chuang, H. F., Chang, C. F., & Fang, T. J. (2017). Implications of Synkinesis in Unilateral Vocal Fold Paralysis. Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 157(6), 1017-1024. https://doi.org/10.1177/0194599817721688
Pei YC, et al. Implications of Synkinesis in Unilateral Vocal Fold Paralysis. Otolaryngol Head Neck Surg. 2017;157(6):1017-1024. PubMed PMID: 28762290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Implications of Synkinesis in Unilateral Vocal Fold Paralysis. AU - Pei,Yu-Cheng, AU - Chang,Wei-Han, AU - Chuang,Hsiu-Feng, AU - Chang,Chia-Fen, AU - Fang,Tuan-Jen, Y1 - 2017/08/01/ PY - 2017/8/2/pubmed PY - 2017/12/12/medline PY - 2017/8/2/entrez KW - idiopathic KW - quantitative laryngeal electromyography KW - reinnervation KW - synkinesis KW - unilateral vocal fold paralysis KW - voice SP - 1017 EP - 1024 JF - Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery JO - Otolaryngol Head Neck Surg VL - 157 IS - 6 N2 - Objectives In patients with unilateral vocal fold paralysis (UVFP), laryngeal electromyography (LEMG) occasionally observes synkinesis in laryngeal muscles, a condition that could impair vocal fold mobility and voice control. This study aims to evaluate the impact of synkinesis on UVFP patients. Study Design A retrospective case-control study. Setting Medical center. Subjects and Methods Patients with UVFP onset >6 months were recruited (N = 104). The outcome measurements included LEMG, quantitative LEMG analysis of thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex, glottal gap measured by videolaryngostroboscopy, voice-related quality of life, and voice acoustic analysis. Results According to the LEMG analysis, 8 patients (8%) had synkinesis, and 96 (92%) did not. In the synkinesis group, TA-LCA turn frequency in the lesioned side was comparable to that in the healthy side (P = .52). Patients in the synkinesis group had higher TA-LCA turn frequency (P = .001), higher probability of cricothyroid muscle dysfunction (P = .04), and better voice-related quality of life (P = .01) but objective voice outcomes comparable to those in the nonsynkinesis group. Conclusions Patients with synkinesis will have near-complete restoration in TA-LCA turn frequency but still experience voice impairment, a finding that is compatible with the mechanism of aberrant reinnervation. However, patients with synkinesis have better disease-related quality of life than do those without synkinesis. SN - 1097-6817 UR - https://www.unboundmedicine.com/medline/citation/28762290/Implications_of_Synkinesis_in_Unilateral_Vocal_Fold_Paralysis_ L2 - http://journals.sagepub.com/doi/full/10.1177/0194599817721688?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -