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The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis.
Laryngoscope. 2020 01; 130(1):139-145.L

Abstract

OBJECTIVES/HYPOTHESIS

Wide variation in postinjury functional recovery is a hallmark of unilateral vocal fold paralysis (UVFP), ranging from zero to full recovery. The present study examined the impact of cricothyroid (CT) muscle involvement on recovery using quantitative laryngeal electromyography (LEMG) of the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex at multiple times postinjury.

STUDY DESIGN

Prospective cohort study in a medical center.

METHODS

Eighty-one patients with UVFP (37 males and 44 females) received an initial assessment of quantitative LEMG, stroboscope, acoustic voice analysis and 36-Item Short Form Survey quality-of-life questionnaire at 3 to 6 months after UVFP onset and a follow-up assessment at 12 months after UVFP onset.

RESULTS

The initial and follow-up assessments were performed at 4.3 ± 1.9 and 12.5 ± 1.3 months after UVFP onset, respectively. The peak turn frequency of the TA-LCA muscle complex on the lesion side was improved at the follow-up (470 ± 294 Hz) compared with the initial assessment (300 ± 204 Hz) (P < .001). Patients were also divided into two groups with (n = 27) and without (n = 54) CT involvement, respectively. TA-LCA muscle complex turn frequency improved in patients without CT involvement (from 277 ± 198 to 511 ± 301 Hz; P < .001), but not in those with CT involvement (from 345 ± 211 to 386 ± 265 Hz; P = .46). Seventy-one of all patients received early intervention with intracordal hyaluronate injection, showing similar therapeutic effects in those with and without CT involvement.

CONCLUSIONS

Acute UVFP with combined TA-LCA muscle complex and CT muscle involvement has a poor prognosis, with poorer recovery of TA-LCA muscle complex recruitment. Early interventions should be considered in patients with UVFP with CT involvement.

LEVEL OF EVIDENCE

2 Laryngoscope, 130:139-145, 2020.

Authors+Show Affiliations

Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. School of Medicine, Chang Gung University, Taoyuan, Taiwan.Department of Otolaryngology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.Graduate School of Management, Ming Chun University, Taipei, Taiwan.Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan. Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Pub Type(s)

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

Language

eng

PubMed ID

30761540

Citation

Fang, Tuan-Jen, et al. "The Impact of Cricothyroid Involvement On Adductor Recovery in Unilateral Vocal Fold Paralysis." The Laryngoscope, vol. 130, no. 1, 2020, pp. 139-145.
Fang TJ, Chuang HF, Chiang HC, et al. The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis. Laryngoscope. 2020;130(1):139-145.
Fang, T. J., Chuang, H. F., Chiang, H. C., & Pei, Y. C. (2020). The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis. The Laryngoscope, 130(1), 139-145. https://doi.org/10.1002/lary.27868
Fang TJ, et al. The Impact of Cricothyroid Involvement On Adductor Recovery in Unilateral Vocal Fold Paralysis. Laryngoscope. 2020;130(1):139-145. PubMed PMID: 30761540.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis. AU - Fang,Tuan-Jen, AU - Chuang,Hsiu-Feng, AU - Chiang,Hui-Chen, AU - Pei,Yu-Cheng, Y1 - 2019/02/13/ PY - 2019/01/24/accepted PY - 2019/2/15/pubmed PY - 2020/7/3/medline PY - 2019/2/15/entrez KW - Unilateral vocal fold paralysis KW - electromyography KW - injection laryngoplasty KW - recurrent laryngeal nerve KW - reinnervation KW - superior laryngeal nerve SP - 139 EP - 145 JF - The Laryngoscope JO - Laryngoscope VL - 130 IS - 1 N2 - OBJECTIVES/HYPOTHESIS: Wide variation in postinjury functional recovery is a hallmark of unilateral vocal fold paralysis (UVFP), ranging from zero to full recovery. The present study examined the impact of cricothyroid (CT) muscle involvement on recovery using quantitative laryngeal electromyography (LEMG) of the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex at multiple times postinjury. STUDY DESIGN: Prospective cohort study in a medical center. METHODS: Eighty-one patients with UVFP (37 males and 44 females) received an initial assessment of quantitative LEMG, stroboscope, acoustic voice analysis and 36-Item Short Form Survey quality-of-life questionnaire at 3 to 6 months after UVFP onset and a follow-up assessment at 12 months after UVFP onset. RESULTS: The initial and follow-up assessments were performed at 4.3 ± 1.9 and 12.5 ± 1.3 months after UVFP onset, respectively. The peak turn frequency of the TA-LCA muscle complex on the lesion side was improved at the follow-up (470 ± 294 Hz) compared with the initial assessment (300 ± 204 Hz) (P < .001). Patients were also divided into two groups with (n = 27) and without (n = 54) CT involvement, respectively. TA-LCA muscle complex turn frequency improved in patients without CT involvement (from 277 ± 198 to 511 ± 301 Hz; P < .001), but not in those with CT involvement (from 345 ± 211 to 386 ± 265 Hz; P = .46). Seventy-one of all patients received early intervention with intracordal hyaluronate injection, showing similar therapeutic effects in those with and without CT involvement. CONCLUSIONS: Acute UVFP with combined TA-LCA muscle complex and CT muscle involvement has a poor prognosis, with poorer recovery of TA-LCA muscle complex recruitment. Early interventions should be considered in patients with UVFP with CT involvement. LEVEL OF EVIDENCE: 2 Laryngoscope, 130:139-145, 2020. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/30761540/The_impact_of_cricothyroid_involvement_on_adductor_recovery_in_unilateral_vocal_fold_paralysis_ L2 - https://doi.org/10.1002/lary.27868 DB - PRIME DP - Unbound Medicine ER -