Demographics, Management, and Outcomes Associated With Idiopathic Vocal Fold Paralysis: A Systematic Review.

Abstract

Objective: Idiopathic vocal fold paralysis (IVFP) is an enigmatic disease that results in voice, breathing, and swallowing impairments. This systematic review provides a comprehensive discussion of the demographics, management, and outcomes of IVFP.

Data sources: PubMed and Embase databases.

Review methods: The PubMed and Embase databases were queried with the keywords "((vocal fold paralysis) OR (vocal cord paralysis)) AND (idiopathic)." Articles were selected if published between 1990 and 2023 and reported data related to patients aged ≥18 years with IVFP. Case studies and reviews were excluded. Participant demographics, presenting symptoms, and spontaneous recovery data were extracted.

Results: The database query identified 509 relevant abstracts, of which 29 studies met the inclusion criteria. A total of 1238 patients with IVFP were identified with a mean age of 55.8 years (range: 40.0-70.2). Patients experienced unilateral IVFP in 97.0% of cases with 67.5% affecting the left side. The most common presenting symptoms were dysphonia (n = 78), dysphagia (n = 41), sore throat (n = 16), and cough (n = 13). Five studies reported time to presentation with a mean of 114.5 days (range: 28-341). Eleven studies found a mean spontaneous recovery rate of 31.6% (range: 11.8%-87.5%) over a mean of 139.4 days (range: 68-180). Only 4.3% of patients were documented to have a viral upper respiratory infection (URI) before developing IVFP. No specific treatments were linked to spontaneous recovery.

Conclusion: There is a paucity of research describing the presentation and outcomes of patients with IVFP. Viral URI may be a potential contributing factor to IVFP development; however, more research is necessary.