Phoniatric evaluation, diagnosis and treatment of voice disorders in the laryngeal nerves paralysis

Abstract

Objective. The aim of the study was to specify and collect important information on the anatomy of the laryngeal nerves and the types of paralysis, as well as paresis and fixation, which is not due to dysfunction of the recurrent laryngeal nerve, but is caused by immobility of the vocal fold as a result of a mechanical obstruction. We focused on the analysis of this condition in terms of clinical symptoms contributing to phoniatric disorders, including dysphonia in the majority of patients with palsy of the laryngeal nerves, as well as the occurrence of dysphagia in slightly more than 30% of people suffering from paralysis. Changes in the patient's quality of life are significant enough to develop the subject in terms of presenting the possibilities of diagnosis, and to present the types of treatment of phoniatric dysfunctions, because an increasing number of patients decide to undergo surgical rehabilitation, including such surgical procedures as thyreoplasty,aimed at improving the quality of life of patients. Review Methods. The focus was on finding the most up-to-date information from the world of science, both on the Internet and in printed literature. Searching Internet resources was carried out with the use of medical publication databases Embase and UpToDate. In addition, part of the bibliography was found on PubMed and PubMed Central. The exploration process was based on key words. A review of the literature was carried out using the basic terms: retrograde laryngeal nerve, in combination with the following entries: paralysis, aphonia, diagnosis, treatment. All the publications selected, with one exception about acute bilateral recurrent palsy of the laryngeal nerve, published in 1988, were published in the 21st century. Special emphasis was placed on presenting the most up-to-date knowledge possible, therefore the vast majority of the literature was published after 2014. Several items published in the current calendar year can be found in the bibliography. Clinical trials were also taken into account, paying particular attention to the number of patients tested, the selection of the research group, research methods and analysis of the results. Many of the online sources found did not meet the selected criteria, most often because the subject was incomplete or the results were reported from too small a group of patients. The criteria adopted while browsing the printed literature were primarily the year of publication and the thematic scope of the issues described.