Repetitive Phonatory Tasks for Identifying Vocal Fold Paresis

The Effect of Topical Anesthesia on Vocal Fold Motion

“…It is useful for identifying dysdiadokinesia. 2,13 A glissando maneuver, asking the patient to slide slowly from his or her lowest to highest note and then slide back down evaluates function of the external division of the SLN. If this branch is injured, longitudinal tension will not increase as effectively on the abnormal side, disparities in vocal fold length will be apparent at higher pitches, and the vocal folds may actually scissor slightly with the normal fold being higher.…”

“…For each examination, patients underwent a standard imaging dynamic voice evaluation protocol. 2 1. Counting 1 to 10, comfortable pitch 2.…”

Injury of the external branch of the superior laryngeal nerve in thyroid surgery

“…Rubin et al (60) proposed that vocal fold hypomobility during fatiguing repetitive phonatory tasks could be diagnostic of EBSLN palsy. However, when mild vocal fold lag is the case, variable degrees of compensation from the unaffected muscles can make hypomobility patterns unreliable to disclose EBSLN dysfunction, as stated by Heman-Ackah and Barr (61) in a retrospective study comparing clinical scenarios, laryngeal findings and LEMG.…”

Vocal Fold Paresis: An Evolving Clinical Concept

“…Using a systematic approach for evaluation, their observations proved to have high interrater reliability. Rubin et al [24] have described the use of repetitive phonatory tasks during examination to fatigue inadequately innervated musculature to accentuate vocal fold hypomobility. Carroll et al [25 • ] have formally described a method used by many to estimate glottic insufficiency using frame-by-frame analysis of the glottal cycle as recorded on stroboscopy.…”

“…Virtually every author to address the subject of paresis has remarked on the discrepancy between clinical observations and electromyographic findings [14 •• , 15 •• , 24,32]. In one series, about one in four patients had electromyographic findings not predicted by the endoscopic examiner [33 • ]; in another, the incidence of unexpected findings was higher still-about 40 % [14 •• ].…”