title: Predictors for Permanent Medialization Laryngoplasty in Unilateral Vocal Fold Paralysis.
abstract: Early differentiation of patients with unilateral vocal fold paralysis (VFP) who recover from those who do not and consequently require permanent medialization laryngoplasty (ML) remains a challenge. The goal of this study is to identify factors that predict the need for ML.
  
  
  
  Case series with chart review.
  
  
  
  Academic center.
  
  
  
  A total of 507 records of patients with VFP were analyzed, of which 252 met criteria and were stratified according to whether or not they obtained ML. Demographic information and clinical features were analyzed to determine predictors of ML. A nomogram was generated according to the significance and utility of these parameters.
  
  
  
  Of 252 patients, 86 underwent ML, and 166 did not. No differences in age or sex were observed between the ML and non-ML patients (P = .27 and P = .35, respectively). The most common cause of VFP was iatrogenic injury (62.79%, ML; 49.40%, non-ML). ML correlated with VFP secondary to neoplastic disease (odds ratio [OR], 2.14; 95% confidence interval [95% CI], 1.01-4.53) and iatrogenic injury (OR 1.73; 95% CI 1.01-2.94). ML had an inverse correlation with idiopathic VFP (OR, 0.40; 95% CI, 0.20-0.79). Patients in the ML group were more likely to have left-sided VFP, to have a history of aspiration, and to present ≥90 days from onset and less likely to have had temporary injection augmentation.
  
  
  
  Clinical features may be used to predict the likelihood of a patient obtaining ML. Nomograms may be useful to counsel patients who would benefit from early definitive surgery.
authors.affiliation: Voice and Swallowing Disorders, Division of Otolaryngology-Head and Neck Surgery, Maimonides Medical Center, Brooklyn, New York, USA Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, New York, USA nivmor73@gmail.com.
authors.forename: Niv
authors.initials: N
authors.lastname: Mor
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Guojiao
authors.initials: G
authors.lastname: Wu
authors.affiliation: College of Physicians and Surgeons, Columbia University, New York, New York, USA.
authors.forename: Alana
authors.initials: A
authors.lastname: Aylward
authors.affiliation: Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christos
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, New York, USA.
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
mesh_terms: D015897:Comorbidity; D005260:Female; D006801:Humans; D058753:Laryngoplasty / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049451:Nomograms; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology / Q000601:surgery*
keywords: laryngeal neuropathy; nomogram; outcome; vocal cord paralysis; vocal fold paralysis