Voice and Swallowing Outcomes after Vocal Fold Medialization in Patients with Unilateral Vocal Fold Paralysis.

Abstract

Background: Unilateral vocal fold paralysis (UVFP) is a common condition that may have varying economical and personal consequences for those afflicted by it. Patients often have dysphonia as a primary concern and may also experience aspiration in certain cases. This research aimed to assess the voice and swallowing results after injection laryngoplasty and medialization thyroplasty in patients with UVFP.

Methods: This prospective study was carried out on 20 consecutive patients suffering from moderate to severe dysphonia with or without aspiration, with ages ranging from 22 to 61 years old, with clinical criteria of UVFP with glottic gap approximately ≥ 2 mm not responding to voice therapy at least 6 months after the onset of paralysis.

Results: All patient showed improvement in their symptoms evaluated by objective (acoustic and aerodynamic), subjective (GRBAS scale and VHI 10) voice assessment and swallowing parameters. MT showed significant improvement when compared to injection laryngoplasty (IL) at 3 months post-operative in contrast to nearly similar outcome at 2 weeks post-operative.

Conclusions: Significant short-term improvements in dysphonia and aspiration were obtained with medialization thyroplasty and injection laryngoplasty. Patients with mild to moderate gaps who complained of dysphonia alone preferred to start with injection, while patients with moderate to large gaps who complained of dysphonia + aspiration preferred MT (±)AA. Even at short time evaluation, medialization thyroplasty is superior to IL for patients with aspiration.