title: Changing trends in the nature of vocal fold motion impairment.
abstract: OBJECTIVE
  Vocal fold motion impairment (VFMI) continues to be a dominant issue in laryngology. The objective of this study is to examine a contemporary population of patients with newly diagnosed VFMI and detect changes in the nature of the cases compared with previous reports.
  
  
  METHODS
  Eighty-four patients with newly diagnosed VFMI are identified from the first author's clinic over a recent 1-year period. Patient demographics, etiology, side, and nature of the impairment are determined from retrospective chart review.
  
  
  RESULTS
  Of the 84 patients, 47 (56%) are women and 37 (44%) are men. The average age of all patients is 53.4 years. Seventy-five (89.3%) of the 84 VFMIs were unilateral, with 11% (9/84) being bilateral. The left side was affected in 52% (39/75) of the patients; the right side was affected in 48% (36/75) of the unilateral cases. The motion impairment was complete in 61.3% (46/75) of the unilateral cases and partial in the remaining 38.7% (29/75). With regard to etiology, iatrogenic causes were the most prevalent with 47.6% (40/84) of the patients. Idiopathic cases comprised 36.9% (31/84) of the patients. Neoplasms (7.1%, 6/84) and miscellaneous causes (7.1%, 6/84) accounted for smaller portions of the remainder. Of the iatrogenic VFMI cases, 27.5% (11/40) followed cervical spine operations. Chest, intracranial, and thyroid surgery accounted for 6 (15%) patients each, as did endotracheal intubation (n = 6, 15%).
  
  
  CONCLUSIONS
  Compared with previous reports, the incidence of iatrogenic cases reviewed here is relatively high. Anterior cervical spine surgery surpassed thyroidectomy and all other procedures as the most common cause of iatrogenic VFMI in this contemporary study.
authors.affiliation: Division of Laryngology, Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA. amerati@mcw.edu
authors.forename: Albert L
authors.initials: AL
authors.lastname: Merati
authors.forename: Nima
authors.initials: N
authors.lastname: Shemirani
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Toohill
mesh_terms: D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014826:Vocal Cord Paralysis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D014827:Vocal Cords / Q000503:physiopathology*