Laryngeal electromyography findings of vocal fold immobility in patients after radiotherapy for nasopharyngeal carcinoma

Hsieh, Yi-Ling; Chang, Ming-Hong; Wang, Chen‐Chi

doi:10.1002/hed.23388

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…1 The additional spread of nerve impairment to the SLN, however, eliminates or at least significantly diminishes unilateral laryngeal sensation, causing aspiration due to failure to develop swallowing compensations. 21,28,30 Finally, the type of abnormality in the swallowing process was informed by the location of the lesion. Reduced tonic and contraction UES pressures were associated with central lesions, suggesting aberrant functioning of the high cervical branches of lower cranial nerves.…”

Section: Discussionmentioning

confidence: 99%

“…RLN injury alone limits impairment to the intrinsic laryngeal musculature with the exception of the cricothyroid muscle 1 . The additional spread of nerve impairment to the SLN, however, eliminates or at least significantly diminishes unilateral laryngeal sensation, causing aspiration due to failure to develop swallowing compensations 21,28,30 . Finally, the type of abnormality in the swallowing process was informed by the location of the lesion.…”

Section: Discussionmentioning

confidence: 99%

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Identifying the Prevalence of Dysphagia among Patients Diagnosed with Unilateral Vocal Fold Immobility

Zhou

Jafri

Husain

2018

Otolaryngol.--head neck surg.

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Objective To identify dysphagia prevalence and characteristics among patients with unilateral vocal fold immobility (UVFI) through a systematic review of current literature. Data Sources Embase, PubMed, ScienceDirect, Wiley Online Library. Review Methods Four electronic databases were reviewed according to the PRISMA criteria. Original English-language studies examining dysphagia among adult patients with UVFI met eligibility. Two researchers independently analyzed qualified articles. Results Of 227 studies discovered through the literature search, 17 satisfied eligibility criteria. The prevalence of symptomatic dysphagia ranged from 55.6% to 69.0%, and the aspiration rate was 20.0% to 50.0%. Self-reporting and clinical evaluation were used to identify symptomatic dysphagia, while videofluoroscopic swallowing study and functional endoscopic evaluation of swallowing evaluated aspiration. Left-sided UVFI predominated. The most common causes of UVFI were iatrogenic and idiopathic. Central lesions and acute-onset UVFI were each associated with more severe dysphagia. Patients were more likely to aspirate on liquids versus purées and pastes. Benefits of medialization thyroplasty and vocal cord injection were equivocal. Conclusion A significant portion of patients with UVFI present with dysphagia due to anatomic and physiologic disruptions during the swallow. Study population heterogeneity and small sample sizes in the reviewed studies may have compromised reliability, calling for large-scale studies with rigorous methodology. Future studies should not only strive to identify the mechanics of the disordered swallow but also explore patients’ quality of life and the effectiveness of current treatments for dysphagia with underlying UVFI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identifying the Prevalence of Dysphagia among Patients Diagnosed with Unilateral Vocal Fold Immobility

Zhou

Jafri

Husain

2018

Otolaryngol.--head neck surg.

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“…Although some suggest that permanent depletion of Schwann cells or nerve ischemia may contribute to functional injury, many suggest that soft tissue fibrosis may be a substantive and more prevalent factor leading to radiation‐associated LCNP than other sources. It is also possible that radiation‐associated LCNP could be caused by central injury to the brainstem nuclei as a result of the higher dose that the bulbar region receives in some conformal methods, such as IMRT that spreads low‐dose bath, circumferentially leading to higher brainstem dose relative to older parallel‐beam methods …”

Section: Discussionmentioning

confidence: 99%

Delayed lower cranial neuropathy after oropharyngeal intensity‐modulated radiotherapy: A cohort analysis and literature review

et al. 2017

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Background To examine swallowing-related lower cranial nerve palsy (LCNP) in oropharyngeal cancer (OPC) survivors after intensity modulated radiotherapy (IMRT). Methods Patients treated with definitive IMRT (66–72 Gy) were pooled from trial databases. Prospective analyses on parent trials included videofluoroscopy, clinical LCNP examination, and questionnaires pre- and 6-, 12-, and 24-months post-IMRT. Time-to-event and incidence of LCNP was estimated with competing risk methods. Literature review (1977–2015) summarized published LCNP outcomes. Results Three of 59 OPC survivors with a minimum 2-year follow-up developed hypoglossal palsy ipsilateral to the index tumor (median latency: 6.7 years, range: 4.6–7.6). At a median of 5.7 years, cumulative incidence of LCNP was 5%. LCNP preceded progressive dysphagia in all cases. Published studies found median incidence of radiation-associated LCNP was 10.5% after NPC, but no OPC-specific estimate. Conclusions While uncommon, the potential for late LCNP preceding swallowing deterioration highlights the importance of long-term functional surveillance in OPC survivorship.

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“…For example, oral cancer patients experienced different degrees of trismus evoked by radiation-induced injury to masticatory muscles after intensity modulation radiated therapy [ 5 , 6 ]. In addition, swallowing and voice disorders were induced by the thyroarytenoid injury after radiation [ 7 , 8 ]. For breast cancer patients, the total radiation field may include the neck, shoulder, axillary, and thoracic muscles.…”

Section: Introductionmentioning

confidence: 99%

Adipose‐Derived Stem Cells Alleviate Radiation‐Induced Muscular Fibrosis by Suppressing the Expression of TGF‐β1

Sun

et al. 2015

Stem Cells International

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We aim to investigate the effects of adipose-derived stem cells (ASCs) transplantation on irradiation-induced skeletal muscle fibrosis. Sixty-four rabbits were randomly divided into ASCs group and PBS group followed by irradiation at unilateral hip with a single dose of 80 Gy. Nonirradiated side with normal skeletal muscle served as normal control. Skeletal muscle tissues were collected from eight rabbits in each group at 1 w, 4 w, 8 w, and 26 w after irradiation. Migration of ASCs was observed in the peripheral tissues along the needle passage in the injured muscle. The proportion of the area of collagen fibers to the total area in sections of ASCs group was lower than those of PBS groups at 4 w, 8 w, and 26 w after irradiation. Significant decrease was noted in the integrated optimal density of the transforming growth factor β1 (TGF-β1) in the ASCs group compared with those of PBS group at 4 w, 8 w, and 26 w after irradiation. Moreover, the expression of TGF-β1 was lower in the ASCs group compared to those of the PBS group at each time point determined by Western blot analysis. ASCs transplantation could alleviate irradiation fibrosis by suppressing the level of TGF-β1 in the irradiated skeletal muscle.

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Laryngeal electromyography findings of vocal fold immobility in patients after radiotherapy for nasopharyngeal carcinoma

Abstract: VFI is usually caused by nerve injury, but it is not a malignant sign of tumor recurrence or metastasis.

Cited by 8 publications

References 15 publications

Identifying the Prevalence of Dysphagia among Patients Diagnosed with Unilateral Vocal Fold Immobility

Identifying the Prevalence of Dysphagia among Patients Diagnosed with Unilateral Vocal Fold Immobility

Delayed lower cranial neuropathy after oropharyngeal intensity‐modulated radiotherapy: A cohort analysis and literature review

Adipose‐Derived Stem Cells Alleviate Radiation‐Induced Muscular Fibrosis by Suppressing the Expression of TGF‐β1

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