title: Pharyngeal weakness and upper esophageal sphincter opening in patients with unilateral vocal fold immobility.
abstract: OBJECTIVE
  To evaluate pharyngeal strength and upper esophageal sphincter opening in patients with unilateral vocal fold immobility (UVFI).
  
  
  METHODS
  Case control study.
  
  
  METHODS
  Charts of individuals with UVFI who underwent a videofluoroscopic swallow study were reviewed. To exclude confounding variables associated with pharyngeal weakness, inclusion was limited to patients with iatrogenic and idiopathic UVFI. Data abstracted included patient demographics, etiology of UVFI, pharyngeal constriction ratio (PCR), and upper esophageal sphincter (UES) opening (UESmax). Data were compared to age/gender-matched controls with no history of dysphagia or UVFI. Discrete variables were analyzed using a chi-square test of independence, and an independent samples t test was used to compare the UVFI and control groups (P = 0.05). A one-way analysis of variance (ANOVA) was used to compare iatrogenic and idiopathic UVFI groups.
  
  
  RESULTS
  The mean age of the cohort (n = 25) was 61 (±14 SD) years and 52% was female. The etiologies of UVFI were iatrogenic (n = 17) and idiopathic (n = 8). Thirty-eight percent of UVFI patients (n = 25) aspirated compared to 0% of controls (P < 0.05). The mean PCR for the UVFI group was 0.14 (±0.02) compared to 0.06 (±.01) for controls (P < 0.05). The mean UESmax for the UVFI group was 0.82 cm (±0.04) compared to 1.0 cm (±0.05) for controls (P > 0.05).
  
  
  CONCLUSIONS
  Individuals with UVFI of iatrogenic and idiopathic etiologies with subjective dysphagia demonstrate objective evidence of pharyngeal weakness. The increased prevalence of aspiration in this population may not be solely the result of impaired airway protection.
authors.affiliation: Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Domer
authors.forename: Rebecca
authors.initials: R
authors.lastname: Leonard
authors.forename: Peter C
authors.initials: PC
authors.lastname: Belafsky
mesh_terms: D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000150:complications / Q000503:physiopathology*; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010608:Pharyngeal Diseases / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014826:Vocal Cord Paralysis / Q000150:complications / Q000503:physiopathology*; D014827:Vocal Cords / Q000503:physiopathology*
keywords: Dysphagia; UVFI; iatrogenic vocal fold immobility; idiopathic vocal fold immobility; swallowing disorder; unilateral vocal fold immobility