在三级护理语音中心治疗急性单侧声带麻痹的全国趋势

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-04-02 DOI:10.1002/lio2.70135

Sydney Ring, Nicholas Colwell, Andrew J. Bowen, Natalia Arroyo, Koffi L. Lakpa, Jaime Faus, Miranda Rasmussen, Peter Nordby, Jiwei Zhao, David O. Francis, the CoPE Collaborative

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引用次数: 0

摘要

目的急性单侧声带麻痹（UVFP）的治疗方法在美国各地有所不同。本研究旨在描述美国三级护理语音中心UVFP治疗的当前趋势。一项调查被分发给51个三级护理语音中心的喉科医生在CoPE（声带麻痹经验）合作。参与者提供了关于声音中心、喉科医生和语言病理学家（SLP）特征、诊断实践、治疗决策和急性UVFP（症状持续≤6个月）的治疗方法的信息。评估了诊断和治疗实践的国家趋势。结果51个CoPE中心中，48个中心完成问卷调查（东北17%，南方33%，中西部35%，西部15%）。大多数中心（77%）有1-2名喉科医生管理急性UVFP， SLP可用性差异很大（每个部位0-8 +）。诊断实践差异很大：只有26%的中心常规测量发声时的平均气流，47%记录最大发声时间（MPT）， 53%评估GRBAS。治疗通常包括声带注射增强，单独或联合声音治疗，通常在诊断后3-4周进行注射（83%）。透明质酸（95%）、PROLARYN GEL（60%）和羟基磷灰石钙（56%）是最常用的材料。注射手术“经常”在诊所进行（90%），“很少”或“从不”在手术室进行（42%）和医院床边进行（56%）。结论三级医疗中心在急性UVFP的诊断、检测、评估和治疗方面存在显著差异。未来的研究需要探索这些变化的原因，并评估多学科方法在优化紫外线射电治疗中的作用。证据水平

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National Trends in Treatment of Acute Unilateral Vocal Fold Paralysis at Tertiary Care Voice Centers

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National Trends in Treatment of Acute Unilateral Vocal Fold Paralysis at Tertiary Care Voice Centers

Objective

Acute unilateral vocal fold paralysis (UVFP) management differs across the United States. This study aims to characterize current trends in UVFP treatment at US tertiary care voice centers.

Data Sources

A survey was distributed to laryngologists at 51 tertiary care voice centers within the CoPE (Vocal Cord Paralysis Experience) Collaborative.

Review Methods

Participants provided information on voice center, laryngologist, and speech-language pathologist (SLP) characteristics, diagnostic practices, treatment decision-making, and therapies offered for acute UVFP (symptoms present for ≤ 6 months). National trends in diagnostic and treatment practices were evaluated.

Results

Among the 51 CoPE centers, 48 completed the questionnaire (17% Northeast, 33% South, 35% Midwest, 15% West). Most centers (77%) had 1–2 laryngologists managing acute UVFP, with SLP availability varying widely (0–8+ per site). Diagnostic practices varied significantly: only 26% of centers routinely measured mean airflow during phonation, 47% recorded maximum phonation time (MPT), and 53% assessed GRBAS. Treatment commonly included vocal fold injection augmentation, alone or combined with voice therapy, with injections typically administered 3–4 weeks after diagnosis (83%). Hyaluronic acid (95%), PROLARYN GEL (60%), and calcium hydroxyapatite (56%) were the most frequently used materials. Injection procedures were performed “often” in clinic settings (90%) and “rarely” or “never” in the operating room (42%) and hospital bedside (56%).

Conclusion

Significant variability exists in the diagnostic testing, evaluation, and treatment of acute UVFP across tertiary care centers. Future studies are warranted to explore the causes of these variations and assess the role of multidisciplinary approaches in optimizing UVFP care.