Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Abstract

The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.

Larynx proteomics after jellyfish collagen IL: Increased ECM/collagen and suppressed inflammation

“…We previously reported on a novel jellyfish “Collagen Type 0” biomaterial for IL that outlasted Cymetra and Restylane, while producing minimal inflammation. 1 The current study investigates the molecular responses to these biomaterials using nLC‐MS/MS analysis of FFPE tissue and Reactome proteomics. We find that (1) MX‐JC is primarily associated with pathways related to upregulation of ECM/collagen, downregulation of inflammation, a switch to energy production through beta acid oxidation and increased proteoglycan synthesis, (2) MACD has biphasic effects on pathways related to inflammation, inhibitory at 4 weeks and proinflammatory at 12 while X‐HA upregulates pro‐inflammatory pathways (Table 1 ), and (3) MACD and X‐HA have opposing regulatory effects on pathways related to proteoglycan metabolism (Table 1 ).…”

“…Unilateral vocal fold paralysis (UVFP) has an estimated incidence of 1–5 per 100,000 in the general population 1 , 2 and a multifactorial etiology, with thyroid and nonthyroid surgery as primary drivers, followed by malignancy and idiopathic causes. 3 Injection medialization laryngoplasty (IL) is a temporary, first‐line treatment for UVFP, that aims to correct voice communication and restore glottal competence.…”

Infiltración temprana en la parálisis laríngea: evolución y factores pronósticos

“…En las guías de práctica clínica de la Sociedad Coreana de Laringología, Foniatría y Logopedia se sugiere realizar la infiltración laríngea en una etapa temprana de la parálisis con inyección de materiales temporales (como es el caso del ácido hialurónico) para prevenir las complicaciones pulmonares y asegurar así la calidad de vida de Ediciones Universidad de Salamanca / [ 7 ] Rev. ORL, 2022, 13, e29825, 1-9 [Publicación continua] un paciente con altas demandas vocales (con un grado de recomendación fuerte y una calidad de evidencia moderada) [10].…”

“…Comparando estos datos con los extraídos de un estudio llevado a cabo en el departamento de Otorrinolaringología del Mount Sinai (Nueva York, EEUU) en pacientes con disfonía, se obtienen conclusiones similares [10]. En este estudio se evaluaron los resultados (VHI-10 score pre/post tratamiento) de los pacientes tratados con inyección grasa vs. tiroplastia de medialización.…”

“…Sin embargo, no todos los pacientes son candidatos óptimos a una infiltración temprana con hialurónico. En el caso de los pacientes con alto riesgo de aspiración, según las guías coreanas nombradas anteriormente, se debe considerar (con un grado de recomendación fuerte y calidad de evidencia moderada) una tiroplastia de medialización en el mismo momento diagnóstico [10].…”