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Long-term outcomes in unilateral vocal fold paralysis patients.
Laryngoscope. 2018 02; 128(2):430-436.L

Abstract

OBJECTIVES/HYPOTHESIS

At presentation, unilateral vocal fold paralysis (UVFP) patients have different treatment options, including conservative management (CM), injection laryngoplasty (IL) with a temporary agent, or permanent medialization (PM). This study evaluates long-term outcomes for UVFP patients relative to intervention.

STUDY DESIGN

Retrospective chart review.

METHODS

A retrospective chart review was performed of UVFP patients who presented to the University of California San Francisco Voice and Swallowing Center. Videolaryngostroboscopy examinations were reviewed. Maximum glottic closure was quantified with the normalized glottic gap area (NGGA). Perceptual voice analysis was performed using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) at corresponding time points.

RESULTS

Fifty-three patients met inclusion criteria. Six underwent CM only, 20 went on to require PM, 19 underwent IL only, and eight underwent IL and subsequent PM. NGGA at presentation was similar among groups; however, the CM group was noted to have more favorable CAPE-V scores for Breathiness (P = .007) and Loudness (P = .018). All groups had similar NGGA and CAPE-V scores at last follow-up. When compared to pooled data for patients who underwent PM, the IL group was noted to have similar NGGA and CAPE-V scores at presentation. Although improvements in both groups were noted following intervention, both groups appeared similar at last follow-up with the exception of Roughness, for which the IL group retained a slightly improved outcome (13.3 vs. 18.3, P = .03).

CONCLUSIONS

At presentation, UVFP patients have similar NGGA. This finding suggests that treatment recommendations cannot be made on the size of the glottic gap alone. Furthermore, in many patients, IL results in long-term benefit with glottic closure and CAPE-V scores equivalent to that obtained with PM.

LEVEL OF EVIDENCE

4. Laryngoscope, 128:430-436, 2018.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.Department of General Surgery, University of California San Francisco, San Francisco, California, U.S.A.Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

29171729

Citation

McLaughlin, Conor W., et al. "Long-term Outcomes in Unilateral Vocal Fold Paralysis Patients." The Laryngoscope, vol. 128, no. 2, 2018, pp. 430-436.
McLaughlin CW, Swendseid B, Courey MS, et al. Long-term outcomes in unilateral vocal fold paralysis patients. Laryngoscope. 2018;128(2):430-436.
McLaughlin, C. W., Swendseid, B., Courey, M. S., Schneider, S., Gartner-Schmidt, J. L., & Yung, K. C. (2018). Long-term outcomes in unilateral vocal fold paralysis patients. The Laryngoscope, 128(2), 430-436. https://doi.org/10.1002/lary.26900
McLaughlin CW, et al. Long-term Outcomes in Unilateral Vocal Fold Paralysis Patients. Laryngoscope. 2018;128(2):430-436. PubMed PMID: 29171729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes in unilateral vocal fold paralysis patients. AU - McLaughlin,Conor W, AU - Swendseid,Brian, AU - Courey,Mark S, AU - Schneider,Sarah, AU - Gartner-Schmidt,Jackie L, AU - Yung,Katherine C, Y1 - 2017/11/24/ PY - 2017/01/08/received PY - 2017/08/11/revised PY - 2017/08/14/accepted PY - 2017/11/25/pubmed PY - 2018/10/6/medline PY - 2017/11/25/entrez KW - Vocal fold paralysis KW - injection laryngoplasty KW - type I thyroplasty SP - 430 EP - 436 JF - The Laryngoscope JO - Laryngoscope VL - 128 IS - 2 N2 - OBJECTIVES/HYPOTHESIS: At presentation, unilateral vocal fold paralysis (UVFP) patients have different treatment options, including conservative management (CM), injection laryngoplasty (IL) with a temporary agent, or permanent medialization (PM). This study evaluates long-term outcomes for UVFP patients relative to intervention. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective chart review was performed of UVFP patients who presented to the University of California San Francisco Voice and Swallowing Center. Videolaryngostroboscopy examinations were reviewed. Maximum glottic closure was quantified with the normalized glottic gap area (NGGA). Perceptual voice analysis was performed using the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) at corresponding time points. RESULTS: Fifty-three patients met inclusion criteria. Six underwent CM only, 20 went on to require PM, 19 underwent IL only, and eight underwent IL and subsequent PM. NGGA at presentation was similar among groups; however, the CM group was noted to have more favorable CAPE-V scores for Breathiness (P = .007) and Loudness (P = .018). All groups had similar NGGA and CAPE-V scores at last follow-up. When compared to pooled data for patients who underwent PM, the IL group was noted to have similar NGGA and CAPE-V scores at presentation. Although improvements in both groups were noted following intervention, both groups appeared similar at last follow-up with the exception of Roughness, for which the IL group retained a slightly improved outcome (13.3 vs. 18.3, P = .03). CONCLUSIONS: At presentation, UVFP patients have similar NGGA. This finding suggests that treatment recommendations cannot be made on the size of the glottic gap alone. Furthermore, in many patients, IL results in long-term benefit with glottic closure and CAPE-V scores equivalent to that obtained with PM. LEVEL OF EVIDENCE: 4. Laryngoscope, 128:430-436, 2018. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/29171729/Long_term_outcomes_in_unilateral_vocal_fold_paralysis_patients_ L2 - https://doi.org/10.1002/lary.26900 DB - PRIME DP - Unbound Medicine ER -