Unilateral vocal fold paralysis: can laryngoscopy predict recovery? A prospective study.
OBJECTIVE
To determine the prognostic value of laryngoscopy in predicting the recovery of unilateral vocal fold paralysis.


METHODS
A prospective study was carried out of all patients with unilateral vocal fold paralysis without a progressive lesion or arytenoid dislocation.


RESULTS
Among the 66 candidates, 15 recovered. Patients with interarytenoid paralysis (p < 0.001) or posterolateral tilt of the arytenoid (p = 0.028) had less chance of recovery. Among 51 patients who did not recover, 25.49 per cent regained phonatory function by compensatory movement of the normal side; the rest required an intervention. Intervention requirement was significantly less for those patients who had isolated glottic level compensation. The paralysed vocal fold was at the same level in 32.35 per cent of patients, higher in 38.23 per cent and lower in 29.42 per cent. In those in whom vocal folds were in the abducted position (46.67 per cent), the affected vocal fold was at a lower position on phonation. Inter-observer reliability assessment revealed excellent to good agreement for all criteria.


CONCLUSIONS
Interarytenoid paralysis and posterolateral tilt of the arytenoid were predictors of poor recovery.
Department of Laryngology,Kerala Institute of Medical Sciences Hospital,Thiruvananthapuram,India.
J K R
JK
Menon
Department of ENT,PVS Memorial Hospital,Kochi,Kerala,India.
R M
RM
Nair
Unit of Speech Language Pathology and Audiology,Department of Neurology,Sree Chitra Tirunal Institute for Medical Sciences and Technology,Thiruvananthapuram,Kerala,India.
S
S
Priyanka
D001193:Arytenoid Cartilage / Q000473:pathology; D004576:Electromyography / Q000379:methods; D005931:Glottis / Q000503:physiopathology; D006801:Humans; D007194:India; D007828:Laryngoscopy / Q000379:methods*; D015588:Observer Variation; D010699:Phonation / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D014827:Vocal Cords / Q000473:pathology*