Phonosurgery for Adult Unilateral Vocal Fold Paralysis

AbstractPurpose of ReviewTo discuss the optimal surgical management for adult unilateral vocal fold paralysis (UVFP).Recent FindingsOffice injection laryngoplasty is a relatively easy procedure that provides immediate vocal improvement and may decrease the need for a future surgical intervention. Type 1 thyroplasty, occasionally with arytenoid adduction (AA), is a standard surgery with good vocal outcomes. Non-selective laryngeal reinnervation (NSLR) improves vocal fold tone and possibly achieves superior vocal outcomes compared to thyroplasty in patients under 55 years, but it is a more complex surgery, with no immediate benefit unless coupled with augmentation. The combination of NSLR with type 1 thyroplasty and AA has shown promising outcomes in patients with vocal fold atrophy and large posterior phonatory gaps.SummarySurgical intervention to improve the voice in an adult patient of UVFP provides good outcomes. The specific procedure should be selected considering time since onset, stroboscopy and laryngeal electromyography (LEMG) findings, patient ’s age, and vocal expectations. Future research in LEMG, pharmacology and targeted laryngeal pacemakers may find non-surgical solutions to this problem.
Source: Current Otorhinolaryngology Reports - Category: ENT & OMF Source Type: research