title: Evidence-based practice: evaluation and management of unilateral vocal fold paralysis.
abstract: This article discusses the causes and symptoms, evaluation, and management of unilateral vocal fold paralysis (UVFP). Cross-sectional imaging is appropriate in the work-up of idiopathic UVFP, but the routine use of serology is not well supported. The usefulness of laryngeal electromyography has remained controversial. Predictors of poor prognosis for functionally meaningful recovery include fibrillation potentials, positive sharp waves, and absent/reduced voluntary motor unit potentials. Voice therapy may be helpful. Injection and laryngeal framework surgery (medialization thyroplasty) improve vocal quality. The vocal impact of laryngeal reinnervation is comparable with that of medialization. Some patients may benefit from multiple procedures.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Minnesota, 420 Delaware Street Southeast, MMC 396, Minneapolis, MN 55455, USA. smisono@umn.edu
authors.forename: Stephanie
authors.initials: S
authors.lastname: Misono
authors.forename: Albert L
authors.initials: AL
authors.lastname: Merati
mesh_terms: D004576:Electromyography / Q000379:methods*; D055317:Evidence-Based Practice; D006801:Humans; D058753:Laryngoplasty / Q000009:adverse effects / Q000379:methods; D011108:Polymers / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D014827:Vocal Cords / Q000000981:diagnostic imaging / Q000294:innervation / Q000503:physiopathology; D014832:Voice Disorders / Q000209:etiology / Q000628:therapy; D014833:Voice Quality; D014834:Voice Training
chemical_list: D011108:Polymers