Arytenoid appearance and vertical level difference between the paralyzed and innervated vocal cords.
OBJECTIVE
In unilateral vocal fold paralysis, it has been generally accepted that the paralyzed vocal fold presents at a higher level than a normally innervated vocal fold. In this study, we correlate the appearances of the paralyzed arytenoid and the differences in level between the paralyzed and innervated vocal folds.


METHODS
Retrospective review using video-recorded images of larynx.


METHODS
A total of 38 patients were selected for this study who reported symptoms of voice change attributable to a paralyzed vocal fold unilaterally. Video recordings were obtained using the laryngeal telescope. The heights were assessed according to the paralyzed positions, status (inspiration or phonation), and appearances of the paralyzed arytenoid. The appearances of paralyzed arytenoid were further clarified as the portions of the medial surface of the arytenoid that were visualized.


RESULTS
In medial paralysis, the paralyzed vocal fold appeared mainly as being at an equal vertical level or as having no distinct difference from normal vocal fold during phonation. However, a few cases of medial paralysis showed a lower than normal or higher than normal vocal fold during phonation, depending on the appearance of the paralyzed arytenoid. In lateral paralysis, most of the paralyzed vocal folds were not higher than the innervated vocal folds during phonation.


CONCLUSIONS
The heights of paralyzed vocal folds were variable depending on the paralyzed positions, the status of the larynx, and appearances of the paralyzed arytenoid. The fact that the paralyzed vocal fold is at a higher level than the normal vocal fold should be reconsidered.
Hong
K H
KH
Department of Otolaryngology--Head and Neck Surgery, Medical School, Institute for Medical Science, Chonbuk National University, Chonju, Korea.
Jung
K S
KS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001193:Arytenoid Cartilage / Q000473:pathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D020704:Laryngoscopes; D008297:Male; D008875:Middle Aged; D010699:Phonation / Q000502:physiology; D012016:Reference Values; D012189:Retrospective Studies; D014741:Video Recording; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000473:pathology*; D014827:Vocal Cords / Q000294:innervation* / Q000473:pathology