Postdeglutitive residue in idiopathic unilateral vocal fold paralysis

Abstract

Idiopathic UVFP patients were more likely to demonstrate increased residue and asymmetry toward the involved region as compared with RLNP patients, suggesting that nerve involvement in idiopathic UVFP may not be exclusive to the RLN.

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

“…The characteristics of articles that met inclusion criteria are displayed in Table 2. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The prevalence of symptomatic dysphagia among patients with UVFI, as identified by self-reporting or clinical evaluation, was 55.6% to 69.0%. In studies that identified swallowing dysfunction mechanistically through videofluoroscopic swallowing study (VFSS) or functional endoscopic evaluation of swallowing (FEES), the aspiration rate ranged from 20.0% to 50.0%.…”

“…Twelve studies reported UVFI laterality, and with the exception of Fang et al, the majority of injuries were left-sided. 8,9,[11][12][13][14][15][16][17][18]20,21 Although left UVFI occurred more frequently, there was no significant difference in the Penetration-Aspiration Scale (PAS) score and no increased risk of aspiration between right and left immobility. 12,15 UVFI etiologies are categorized in Table 3 as iatrogenic (6.7%-68.0%), noniatrogenic trauma (3.1%-26.7%), neoplasm (3.6%-47.4%), medical disease (4.2%-29.6%), mechanical (4.2%), and idiopathic (6.3%-60.6%).…”

“…2 Five studies had to be excluded from analysis of etiology: Bhattacharyya et al, since iatrogenic and neoplasm data could not be separated 13 ; Leder and Ross, because their etiology data pertained to unilateral and bilateral vocal fold immobility 15 ; and Flint et al, Jang et al, and Narajos et al, because they did not report etiologies for RLN or RLN/SLN injuries. 10,19,21 Studies also examined the association between severity of dysphagia presentation and temporal onset of UVFI, etiology of UVFI, or lesion location. Temporality of vocal fold injury and its relation to dysphagia were examined by Fang et al 18 Patients were divided into 2 groups: those who acquired unilateral vagus nerve damage suddenly after surgery, skull base fracture, hemorrhage, or cerebrovascular accident and those who acquired vagal damage gradually through skull base neoplasm and Chiari type I malformation.…”

Postdeglutitive residue in vagus nerve paralysis and its association with feeding style

“…4 The affected vallecula of Group I did not demonstrate significantly increased residue compared to the non-affected side (a), and the same comparison in Group II also did not demonstrate any significant difference (b). Compared to Group II, Group I did not have significantly more residue on the vallecula of the affected or non-affected side group previously demonstrated that idiopathic UVFP patients are more likely to demonstrate increased residue and asymmetry towards the involved pharyngeal region compared to patients with isolated RLNP [13]. This suggests that the nerve involvement in idiopathic UVFP is more extensive compared to patients with vagus or superior laryngeal nerve paralysis, because it is not limited to the RLN.…”

“…With respect to this limitation, we validated the quantitative measurement of the area outlined in the lateral view of the VFSS still image by calculating inter-and intra-rater correlation coefficients, which were all found to be in the excellent range (0.88-0.92), demonstrating a high consistency and stability in the evaluation. In addition, we previously verified this method [13].…”