title: Inpatient injection laryngoplasty for vocal fold immobility: When is it really necessary?
abstract: OBJECTIVE
  To compare pulmonary and swallow outcomes of injection laryngoplasty when performed in the acute versus subacute setting in head & neck and thoracic cancer patients presenting with new onset unilateral vocal fold immobility.
  
  
  METHODS
  Case series with chart review at an academic cancer center over a 2year period. Based on swallow evaluation, patients diagnosed with vocal fold immobility were grouped into an unsafe swallow group, injected as inpatients, and a safe swallow group, for whom injection laryngoplasty was delayed to the outpatient setting or not performed. Rates of pneumonia, diet recommendations, and swallow outcomes were compared between groups.
  
  
  RESULTS
  24 patients with new-onset vocal fold immobility were evaluated. 7 underwent injection in the inpatient setting, 12 in the outpatient setting, and 5 did not undergo injection. There was no perceived difference in speech and swallow outcomes between the inpatient and outpatient injection groups.
  
  
  CONCLUSIONS
  Injection laryngoplasty shows promise as an effective intervention for reducing aspiration risk and improving diet normalcy in patients with dysphagia as a result of unilateral vocal fold immobility. In patients determined to have a safe swallow, delay of injection laryngoplasty is not detrimental to swallow outcomes.
authors.affiliation: Department of Otolaryngology, Lewis Katz School of Medicine at Temple University, 3440 N. Broad Street, Kresge West #300, Philadelphia, PA 19140, United States. Electronic address: Steven.Zuniga@tuhs.temple.edu.
authors.forename: Steven
authors.initials: S
authors.lastname: Zuniga
authors.affiliation: Department of Otolaryngology, Lewis Katz School of Medicine at Temple University, 3440 N. Broad Street, Kresge West #300, Philadelphia, PA 19140, United States; Department of Speech Pathology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ebersole
authors.affiliation: Department of Otolaryngology, Lewis Katz School of Medicine at Temple University, 3440 N. Broad Street, Kresge West #300, Philadelphia, PA 19140, United States; Department of Surgical Oncology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, 333 Cottman Avenue, Philadelphia, PA 19111, United States.
authors.forename: Nausheen
authors.initials: N
authors.lastname: Jamal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications; D006801:Humans; D007267:Injections; D058753:Laryngoplasty / Q000379:methods*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013899:Thoracic Neoplasms / Q000150:complications; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000628:therapy*
keywords: Dysphagia; Injection laryngoplasty; Swallow outcomes; Vocal fold immobility