Over-adduction of the unaffected vocal fold during phonation in the unilaterally paralyzed larynx.
CONCLUSIONS
Over-adduction of the unaffected vocal fold may not compensate vocal function in unilateral vocal fold paralysis (UVFP).


OBJECTIVE
To determine whether over-adduction of the unaffected vocal fold has any impact on vocal function in patients with UVFP.


METHODS
A total of 101 patients with UVFP who underwent three-dimensional computed tomographic (CT) examination of the larynx served as subjects. Three-dimensional endoscopic images together with coronal images during phonation were produced to evaluate over-adduction of the unaffected fold, posterior glottal gap, and differences in the vertical position and thickness between the vocal folds. Maximum phonation time (MPT) and mean airflow rate (MFR) were measured.


RESULTS
In all, 47 patients showed over-adduction. Their MPT and MFR were 4.9 ± 2.9 s and 653 ± 504 ml/s, respectively. The remaining 54 did not show over-adduction. Their MPT and MFR were 4.7 ± 2.7 s and 574 ± 384 ml/s, respectively. There were no significant differences in MPT or MFR between the two groups. Of the 47 patients with over-adduction, 9 showed no posterior glottal gap. However, their vocal function was not significantly different from that of 38 patients with posterior glottal gap or from that of 43 patients without over-adduction and having a posterior glottal gap.
Department of Otolaryngology - Head and Neck Surgery, Graduate School of Medicine, Kumamoto University , Kumamoto , Japan.
Eiji
E
Yumoto
Tetsuji
T
Sanuki
Ryosei
R
Minoda
Yoshihiko
Y
Kumai
Kohei
K
Nishimoto
Narihiro
N
Kodama
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D055154:Dysphonia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004724:Endoscopy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D010699:Phonation / Q000502:physiology*; D049489:Stroboscopy; D014826:Vocal Cord Paralysis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D014827:Vocal Cords / Q000503:physiopathology*
Unilateral vocal fold paralysis; compensatory adduction of the mobile vocal fold; posterior glottal gap; vocal function