Effect of vocal fold medialization on dysphagia in patients with unilateral vocal fold immobility

Daniel Cates, Naren N. Venkatesan, Brandon Strong, Maggie Kuhn, Peter C Belafsky

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores. Results Forty-four patients met criteria and underwent either vocal fold injection (73%) or thyroplasty (27%). Etiologies of vocal fold paralysis were iatrogenic (55%), idiopathic (29%), benign or malignant neoplastic (9%), traumatic (5%), or related to the late effects of radiation (2%). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P <.01) with a follow-up of 119 ± 65 days. Conclusion Patients with UVFI suffer from dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time.

Original languageEnglish (US)
Pages (from-to)454-457
Number of pages4
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume155
Issue number3
DOIs
StatePublished - Sep 1 2016

Fingerprint

Vocal Cords
Deglutition Disorders
Deglutition
Laryngoplasty
Radiation Effects
Tertiary Care Centers
Paralysis
Eating
Demography
Databases

Keywords

  • dysphagia
  • EAT-10
  • Eating Assessment Tool
  • injection laryngoplasty
  • medialization thyroplasty
  • unilateral vocal fold paralysis
  • VHI
  • Voice Handicap Index

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Effect of vocal fold medialization on dysphagia in patients with unilateral vocal fold immobility. / Cates, Daniel; Venkatesan, Naren N.; Strong, Brandon; Kuhn, Maggie; Belafsky, Peter C.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 155, No. 3, 01.09.2016, p. 454-457.

Research output: Contribution to journalArticle

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abstract = "Objective The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores. Results Forty-four patients met criteria and underwent either vocal fold injection (73{\%}) or thyroplasty (27{\%}). Etiologies of vocal fold paralysis were iatrogenic (55{\%}), idiopathic (29{\%}), benign or malignant neoplastic (9{\%}), traumatic (5{\%}), or related to the late effects of radiation (2{\%}). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P <.01) with a follow-up of 119 ± 65 days. Conclusion Patients with UVFI suffer from dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time.",
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N2 - Objective The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores. Results Forty-four patients met criteria and underwent either vocal fold injection (73%) or thyroplasty (27%). Etiologies of vocal fold paralysis were iatrogenic (55%), idiopathic (29%), benign or malignant neoplastic (9%), traumatic (5%), or related to the late effects of radiation (2%). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P <.01) with a follow-up of 119 ± 65 days. Conclusion Patients with UVFI suffer from dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time.

AB - Objective The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores. Results Forty-four patients met criteria and underwent either vocal fold injection (73%) or thyroplasty (27%). Etiologies of vocal fold paralysis were iatrogenic (55%), idiopathic (29%), benign or malignant neoplastic (9%), traumatic (5%), or related to the late effects of radiation (2%). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P <.01) with a follow-up of 119 ± 65 days. Conclusion Patients with UVFI suffer from dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time.

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