Effects of percutaneous injection laryngoplasty on voice and swallowing problems in <scp>cancer‐related</scp> unilateral vocal cord paralysis

Kang, Min Gu; Seo, Han Gil; Chung, Eun Jae; Lee, Hyun Haeng; Yun, Seo Jung; Keam, Bhumsuk; Kim, Tae Min; Kwon, Seong Keun; Oh, Byung Mo

doi:10.1002/lio2.618

Cited by 6 publications

(9 citation statements)

References 27 publications

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“…Also, there was no significant difference between either group regarding presence of residue 1week and 3 months postintervention. This is in agreement with Kang et al [17] who reported by videofluoroscopic dysphagia scale that no significant improvement in presence of vallecular or pharyngeal residue because IML improves glottic incompetence, but injection laryngoplasty (IL) cannot enhance the sensory abnormalities of the larynx owing to the inconsistent timing of the procedure. Patients who got injectable laryngoplasty after 8 weeks of symptoms start demonstrated more significant improvements compared to those who underwent the surgery after 8 weeks or longer.…”

Section: Discussionsupporting

confidence: 92%

Behavioral Readjustment Therapy versus Vocal Fold Injection in the Management of Swallowing Disorders in Cases of Unilateral Vocal Fold Paralysis

2024

The Egyptian Journal of Hospital Medicine

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Background: Unilateral vocal fold immobility (UVFI) is the most prevalent neurological disease affecting the larynx. Objective: This work aimed to evaluate management of oropharyngeal dysphagia in cases of unilateral vocal fold paralysis (UVFP) by either behavioral readjustment therapy (BRAT) or vocal fold injection (VFI) to provide the best management technique regarding safety and effectiveness in these patients. Methods: This study was carried out on 20 consecutive candidates of both sexes with vocal fold immobility and dysphagia for BRAT or VFI. They were aged from 20 to 60 years old, both sexes. Patients were divided randomly into two equal groups: Group I included odd numbers received BRAT with mean age of 42.3 ± 15.21 years and group II that included even numbers received VFI with mean age of 45.1 ± 12.56. Results: The glottic gap was significantly better in one week and three months follow-up for injection group than behavioral group. The presence of the residue one week post intervention showed non-significant difference between both groups. Penetration aspiration scale (PAS) after one week and 3 months of intervention for fluids showed a significant difference between both groups but PAS for semisolids and solids showed no significant difference between them. Food consistency was affected and choking of fluid showed a significant difference in both groups. Conclusions: Injection laryngoplasty (IL) and BRAT could improve oropharyngeal dysphagia in patients with unilateral VFP. IL improved the glottal closure, therefore it improved airway protection and increased cough power, so it helps to prevent aspiration. BRAT improved motor power and motor control of swallowing in oropharyngeal phase, improved impaired sensation, improved bolus flow, and decreased the patient's symptoms.

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Section: Discussionsupporting

confidence: 92%

Behavioral Readjustment Therapy versus Vocal Fold Injection in the Management of Swallowing Disorders in Cases of Unilateral Vocal Fold Paralysis

2024

The Egyptian Journal of Hospital Medicine

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“…Prior studies offer a wide range of follow‐up times between IL and instrumental swallowing assessments, ranging from days to years. 10 , 13 , 14 , 15 , 17 Ultimately, there has been no clear data on the anticipated time to aspiration recovery for vocal cord injection pediatric patients. This timeline variability can distort improvement percentages, as children may naturally experience a spontaneous improvement in dysphagia and vocal cord function over time without interventions.…”

Section: Discussionmentioning

confidence: 99%

Injection Laryngoplasty for Children with Dysphagia after Cardiac Surgery

Sheen,

Houser,

Olsson

et al. 2024

OTO Open

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ObjectiveTo determine whether injection laryngoplasty (IL) resolves thin liquid aspiration among children with unilateral vocal cord paralysis (UVCP) after cardiac surgery.Study DesignRetrospective case‐control.SettingTertiary children's hospital.MethodsConsecutive children (<5 years) between 2012 and 2022 with UVCP after cardiac surgery were included. Resolution of thin liquid aspiration after IL versus observation was determined for children obtaining videofluoroscopic swallow studies (VFSS).ResultsA total of 32 children with left UVCP after cardiac surgery met inclusion. Initial surgeries were N = 9 (28%) patent ductus arteriosus ligations, N = 7 (22%) aortic arch surgeries, N = 9 (28%) surgeries for hypoplastic left heart syndrome, and N = 7 (22%) other cardiac surgeries. The mean age at initial surgery was 1.8 months (SD: 3.7). All children had a VFSS obtained after surgery that confirmed aspiration. There were 17 children that obtained an IL at 33.6 months (SD: 20.9) after cardiac surgery and 15 children observed without IL procedure. No surgical complications after IL were noted. The rate of aspiration resolution based on postoperative VFSS was N = 14 (82%) for the IL group and N = 9 (60%) for the control group P = .24. Documented VFSS aspiration resolution after cardiac surgery occurred by 9.6 months (SD: 10.0) in the observation group and 47.4 months (SD: 24.1) in the IL group (P < .001).ConclusionIL can help treat aspiration in children with UVCP after cardiac surgery but the benefit beyond observation remains unclear. Future studies should continue to explore the utility for IL in managing dysphagia in this pediatric population.

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“…However, although better glottic closure could theoretically contribute to better swallowing function, limited literature has assessed swallowing pathology after medialization surgery on patients with UVFP. Particularly, few studies reported the swallowing impact of ML + AA on patients with UVFP while recent several studies assessed the effectiveness of IL on swallowing function 8–11 …”

Section: Introductionmentioning

confidence: 99%

“…Particularly, few studies reported the swallowing impact of ML + AA on patients with UVFP while recent several studies assessed the effectiveness of IL on swallowing function. [8][9][10][11] In this study, we evaluated swallowing function before and after vocal fold medialization surgery in patients with UVFP. Furthermore, we comparatively analyzed the differences in swallowing impact between IL and ML + AA.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of vocal fold medialization surgery on the swallowing function of patients with unilateral vocal fold paralysis

Kono

Tomisato

Ozawa

2023

Laryngoscope Investig Oto

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ObjectivesVocal fold medialization surgery is generally considered a phonosurgical procedure for improvement of vocal function in patients with glottic insufficiency. However, the literature describing this procedure for the management of dysphagia is limited. This study aims to assess the effects of medialization surgery on swallowing function in patients with unilateral vocal fold paralysis (UVFP).MethodsWe enrolled 32 patients with UVFP undergoing vocal fold medialization surgery (medialization laryngoplasty combined with arytenoid adduction [ML + AA], 12 cases; injection laryngoplasty [IL], 20 cases). We assessed the aerodynamic vocal function including maximum phonation time and mean flow rate to evaluate glottal closure status. The Hyodo score determined by flexible endoscopic evaluation and Functional Oral Intake Scale (FOIS) were evaluated pre‐ and postoperatively.ResultsAlmost 60% of patients with UVFP had dysphagia, and one‐third were at high risk for aspiration. Aerodynamic parameters effectively improved after IL and ML + AA. With regard to swallowing, both the FOIS and total Hyodo score were significantly improved postoperatively. We found a particularly significant improvement in pharyngeal clearance. However, patients with high vagal nerve paralysis and postoperative insufficient glottal closure showed poor swallowing benefits after the interventions. In patients with recurrent laryngeal nerve palsy, there were no significant differences in postoperative swallowing function between the ML + AA and IL groups.ConclusionVocal fold medialization surgery was effective in improving swallowing function in most cases with UVFP, except for those with high vagal paralysis and insufficient postoperative glottal closure. Both IL and ML + AA showed an equivalent effect on swallowing improvement.Level of evidence3b.

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Effects of percutaneous injection laryngoplasty on voice and swallowing problems in cancer‐related unilateral vocal cord paralysis

Cited by 6 publications

References 27 publications

Behavioral Readjustment Therapy versus Vocal Fold Injection in the Management of Swallowing Disorders in Cases of Unilateral Vocal Fold Paralysis

Behavioral Readjustment Therapy versus Vocal Fold Injection in the Management of Swallowing Disorders in Cases of Unilateral Vocal Fold Paralysis

Injection Laryngoplasty for Children with Dysphagia after Cardiac Surgery

Effectiveness of vocal fold medialization surgery on the swallowing function of patients with unilateral vocal fold paralysis

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