title: Effect of Vocal Fold Medialization on Dysphagia in Patients with Unilateral Vocal Fold Immobility.
abstract: The effect of vocal fold medialization (VFM) on vocal improvement in persons with unilateral vocal fold immobility (UVFI) is well established. The effect of VFM on the symptom of dysphagia is uncertain. The purpose of this study is to evaluate dysphagia symptoms in patients with UVFI pre- and post-VFM.
  
  
  
  Case series with chart review.
  
  
  
  Academic tertiary care medical center.
  
  
  
  The charts of 44 persons with UVFI who underwent VFM between June 1, 2013, and December 31, 2014, were abstracted from a prospectively maintained database at the University of California, Davis, Voice and Swallowing Center. Patient demographics, indications, and type of surgical procedure were recorded. Self-reported swallowing impairment was assessed with the validated 10-item Eating Assessment Tool (EAT-10) before and after surgery. A paired samples t test was used to compare pre- and postmedialization EAT-10 scores.
  
  
  
  Forty-four patients met criteria and underwent either vocal fold injection (73%) or thyroplasty (27%). Etiologies of vocal fold paralysis were iatrogenic (55%), idiopathic (29%), benign or malignant neoplastic (9%), traumatic (5%), or related to the late effects of radiation (2%). EAT-10 (mean ± SD) scores improved from 12.2 ± 11.1 to 7.7 ± 7.2 after medialization (P < .01) with a follow-up of 119 ± 65 days.
  
  
  
  Patients with UVFI suffer from dysphagia and report significant improvement in swallowing symptoms following VFM. The symptomatic improvement appears to be durable over time.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis, Sacramento, California, USA djcates@ucdavis.edu.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Cates
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
authors.forename: Naren N
authors.initials: NN
authors.lastname: Venkatesan
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Strong
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
authors.forename: Maggie A
authors.initials: MA
authors.lastname: Kuhn
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Belafsky
mesh_terms: D003131:Combined Modality Therapy; D003680:Deglutition Disorders / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007267:Injections; D058753:Laryngoplasty / Q000379:methods; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D014741:Video Recording; D014826:Vocal Cord Paralysis / Q000503:physiopathology* / Q000628:therapy*; D014833:Voice Quality
keywords: EAT-10; Eating Assessment Tool; VHI; Voice Handicap Index; dysphagia; injection laryngoplasty; medialization thyroplasty; unilateral vocal fold paralysis