Swallowing dysfunction in patients with unilateral vocal fold paralysis: aetiology and outcomes

Abstract

Although unilateral vocal fold palsy (UVFP) is a common problem, data relating to swallowing dysfunction are sparse. We reviewed the clinical findings (method of presentation, underlying diagnosis and position of the vocal folds) of 30 patients and conducted a follow-up telephone survey. Outcome measures used were direct visualization of fold function, position and compensation. In addition, standardized speech and language assessments for swallowing dysfunction and dysphonia were noted and compared to presentation. Our study indicates that 56 per cent of patients with UVFP have associated dysphagia. Outcome with speech therapy is significant, with 73 per cent showing improvement. These data indicate a significant link between UVFP and swallowing dysfunction. There is a marked therapeutic benefit from voice therapy. Further work is required to evaluate the long-term outcomes and establish the mechanism of swallowing dysfunction in these patients.

Analysis of Video Fluoroscopic Swallowing Study in Patients with Vocal Cord Paralysis

“…Most studies of patients with VCP have concluded that the main cause of dysphagia is the reduced mechanical protection of the glottis [4–6]. However, Tabaee et al [6] reported that pharyngeal sensory impairment is involved, and Battacharyya et al [8] suggested that diminished cough strength is also an important cause.…”

“…Previous studies have reported that nearly 56% of patients with VCP have swallowing dysfunction [4, 5]. Tabaee et al [6] suggested that dysphagia in patients with VCP has multifactorial causes, including limited airway protection and decreased laryngopharyngeal sensation based on the findings of flexible endoscopy.…”

Neurophysiology of swallowing: Effects of age and bolus type

“…Therefore, it is difficult to identify, with certainty, swallowing hemispheric dominance for head and neck sensation and movement given the tasks from this study. Yet, unilateral paralysis (Ollivere et al, 2006) or paresis (Vigderman et al, 1998) of head or neck musculature can result in serious swallowing disability, as can unilateral cortical damage secondary to stroke (Daniels and Foundas, 1997; Robbins et al, 1993). The right-sided activity in the older group of the current study might indicate a normal shift toward right-hemispheric activity for swallowing with healthy aging.…”

Swallowing Evaluation in Patients with Unilateral Vocal Fold Immobility

“…The immobility may be caused by neck and thoracic surgery, which can impair the innervation of the pharynx, upper esophageal sphincter (UES), and proximal esophagus, but may also be due to malignancy, trauma, intracranial causes, or may be idiopathic [4,5].…”