eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Laryngology

Vocal Fold Paralysis, Unilateral: Follow-up

Author: Thomas L Carroll, MD, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Tufts University School of Medicine
Coauthor(s): Clark A Rosen, MD, Director, University of Pittsburgh Voice Center; Associate Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine; Ryan J Soose, MD, Assistant Professor, Department of Otolaryngology, University of Pittsburgh Medical Center
Contributor Information and Disclosures

Updated: Nov 6, 2008

Outcome and Prognosis

Expected voice outcome following the treatment for unilateral vocal fold paralysis (UVFP) is excellent. Most patients resume normal speaking activities and functions and are able to meet all normal voice demands. Singing is a higher demand than speaking and may not be restored to its premorbid condition. The ability to project one's voice over a large area in a loud manner is also often never fully restored despite optimal medical, behavioral, and surgical treatment. Most patients should have a normal or near-normal speaking voice ability with minimal to no functional limitations of their everyday voice use following successful treatment.

Future and Controversies

Understand that present surgical treatments only provide static improvement to the vocal fold and cannot provide the dynamic activity of the vocal fold to voice production that was present in the premorbid state. 

Thus, the future goal of laryngology research is to create a method of dynamic rehabilitation of the paralyzed vocal fold. This goal has been present for decades, and much work has been devoted to the concept of reinnervation of the vocal fold. In humans, the optimal result from reinnervation is a static vocal fold but one that has tone. Often, laryngeal reinnervation is performed simultaneously or sequentially with medialization laryngoplasty. The future of laryngeal reinnervation is unknown but serves as a vast area for research and progress.

 


More on Vocal Fold Paralysis, Unilateral

Overview: Vocal Fold Paralysis, Unilateral
Workup: Vocal Fold Paralysis, Unilateral
Treatment: Vocal Fold Paralysis, Unilateral
Follow-up: Vocal Fold Paralysis, Unilateral
Multimedia: Vocal Fold Paralysis, Unilateral
References
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References

  1. Caton T, Thibeault SL, Klemuk S, et al. Viscoelasticity of hyaluronan and nonhyaluronan based vocal fold injectables: implications for mucosal versus muscle use. Laryngoscope. Mar 2007;117(3):516-21. [Medline].

  2. Zeitels SM, Hillman RE, Desloge RB, et al. Cricothyroid subluxation: a new innovation for enhancing the voice with laryngoplastic phonosurgery. Ann Otol Rhinol Laryngol. Dec 1999;108(12):1126-31. [Medline].

  3. Amin MR. Thyrohyoid approach for vocal fold augmentation. Ann Otol Rhinol Laryngol. Sep 2006;115(9):699-702. [Medline].

  4. Belafsky PC, Postma GN. Vocal fold augmentation with calcium hydroxylapatite. Otolaryngol Head Neck Surg. Oct 2004;131(4):351-4. [Medline].

  5. Bielamowicz S, Stager SV. Diagnosis of unilateral recurrent laryngeal nerve paralysis: laryngeal electromyography, subjective rating scales, acoustic and aerodynamic measures. Laryngoscope. Mar 2006;116(3):359-64. [Medline].

  6. Branski R, Murry T, Rosen CA. Voice Therapy. In: Otolaryngology and Facial Plastic Surgery. 2000:[Full Text].

  7. Carrau RL, Pou A, Eibling DE. Laryngeal framework surgery for the management of aspiration. Head Neck. Mar 1999;21(2):139-45. [Medline].

  8. Hertegard S, Hallen L, Laurent C, et al. Cross-linked hyaluronan versus collagen for injection treatment of glottal insufficiency: 2-year follow-up. Acta Otolaryngol. Dec 2004;124(10):1208-14. [Medline].

  9. Hunsaker DH, Martin PJ. Allergic reaction to solid silicone implant in medial thyroplasty. Otolaryngol Head Neck Surg. Dec 1995;113(6):782-4. [Medline].

  10. Jacobson BH, Johnson A, Grywalski C. The Voice Handicap Index (VHI): Development and Validation. American Journal of Speech-Language Pathology. 1997;6:66-70.

  11. Kwon TK, Buckmire R. Injection laryngoplasty for management of unilateral vocal fold paralysis. Curr Opin Otolaryngol Head Neck Surg. Dec 2004;12(6):538-42. [Medline].

  12. Laccourreye O, Papon JF, Kania R, et al. Intracordal injection of autologous fat in patients with unilateral laryngeal nerve paralysis: long-term results from the patient's perspective. Laryngoscope. Mar 2003;113(3):541-5. [Medline].

  13. Miller S. Voice therapy for vocal fold paralysis. Otolaryngol Clin North Am. Feb 2004;37(1):105-19. [Medline].

  14. Milstein CF, Akst LM, Hicks MD, et al. Long-term effects of micronized Alloderm injection for unilateral vocal fold paralysis. Laryngoscope. Sep 2005;115(9):1691-6. [Medline].

  15. Munin MC, Rosen CA, Zullo T. Utility of laryngeal electromyography in predicting recovery after vocal fold paralysis. Arch Phys Med Rehabil. Aug 2003;84(8):1150-3. [Medline].

  16. Noordzij JP, Perrault DF, Woo P. Biomechanics of combined arytenoid adduction and medialization laryngoplasty in an ex vivo canine model. Otolaryngol Head Neck Surg. Dec 1998;119(6):634-42. [Medline].

  17. Rosen CA. Complications of phonosurgery: results of a national survey. Laryngoscope. Nov 1998;108(11 Pt 1):1697-703. [Medline].

  18. Rosen CA. Phonosurgical vocal fold injection: indications and techniques. Operative Techniques in Otolaryngology Head and Neck Surgery. 1998;9(4):203-209. [Medline].

  19. Rosen CA, Thekdi AA. Vocal fold augmentation with injectable calcium hydroxylapatite: short-term results. J Voice. Sep 2004;18(3):387-91. [Medline].

  20. Shaw GY, Szewczyk MA, Searle J, et al. Autologous fat injection into the vocal folds: technical considerations and long-term follow-up. Laryngoscope. Feb 1997;107(2):177-86. [Medline].

  21. Umeno H, Shirouzu H, Chitose S, et al. Analysis of voice function following autologous fat injection for vocal fold paralysis. Otolaryngol Head Neck Surg. Jan 2005;132(1):103-7. [Medline].

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Further Reading

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Keywords

unilateral vocal fold paralysis, UVFP, vocal cord paralysis, neurogenic hoarseness, vocal cord paralysis, larynx, neurogenic hoarseness

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Contributor Information and Disclosures

Author

Thomas L Carroll, MD, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Tufts Medical Center, Tufts University School of Medicine
Thomas L Carroll, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Clark A Rosen, MD, Director, University of Pittsburgh Voice Center; Associate Professor, Department of Otolaryngology and Communication Science and Disorders, University of Pittsburgh School of Medicine
Clark A Rosen, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Pennsylvania Medical Society
Disclosure: Bioform Medical  Consulting fee Consulting

Ryan J Soose, MD, Assistant Professor, Department of Otolaryngology, University of Pittsburgh Medical Center
Ryan J Soose, MD is a member of the following medical societies: Alpha Omega Alpha and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

John Schweinfurth, MD, Associate Professor, Department of Otolaryngology, University of Mississippi Medical Center
John Schweinfurth, MD is a member of the following medical societies: American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Robert M Kellman, MD, Professor and Chair, Department of Otolaryngology and Communication Sciences, State University of New York, Upstate Medical University
Robert M Kellman, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Rhinologic Society, American Society for Head and Neck Surgery, Medical Society of the State of New York, and Triological Society
Disclosure: GE Healthcare Honoraria Review panel membership

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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