Trends in Etiology and Outcomes of Acquired Unilateral Vocal Fold Paralysis: A Multicenter Retrospective Study in Peninsular Malaysia.

Abstract

Introduction: Unilateral vocal fold paralysis (UVFP) results from either mechanical or neurological causes, significantly impacting voice, breathing, and swallowing functions. Thyroid and parathyroid surgeries are commonly implicated as surgical causes; however, non-surgical etiologies remain diverse. Some studies have suggested a change in the trend of UVFP etiologies over time, likely due to advancements in surgical techniques, improved diagnostics, and evolving healthcare practices. This study examines trends in etiology and outcomes of UVFP with early interventions in a multicenter setting in Malaysia over two decades.

Methods: A retrospective, multicenter review of UVFP cases was conducted over two periods: 2004-2012 and 2013-2021. Data on patient demographics, UVFP etiology, laterality, and intervention outcomes were analyzed. Interventions included voice therapy alone or in combination with early surgical interventions. Statistical analysis was performed to compare trends and outcomes across periods.

Results: Thyroid and parathyroid surgeries remained the predominant surgical cause of UVFP. Iatrogenic UVFP was more commonly right-sided, while non-surgical cases predominantly involved the left side. No significant differences were observed in the distribution of surgical and non-surgical etiologies between the two study periods. Early interventions demonstrated significantly better voice outcomes compared to voice therapy alone (p < 0.05).

Conclusion: This is the first long-term, multicenter study in Malaysia addressing UVFP trends and outcomes. Early surgical interventions provide superior outcomes compared to conservative approaches, highlighting the need for timely diagnosis and management to optimize patient care.