Etiology, pathophysiology, treatment choices, and voice results for unilateral adductor vocal fold paralysis: A 3-year retrospective

Unilateral vocal fold paralysis is now considered a common disorder seen in the practice of otolaryngology and voice pathology. Concern first is for t he accurate diagnosis of the associated etiology in an efficient and thorou gh fashion. When etiology has been determined the focus of treatment become s the management of the presenting symptoms, which typically include dyspho nia and dysphagia. A retrospective study was conducted reviewing the record s of 117 patients with unilateral adductor vocal fold paralysis who present ed to a large otolaryngology practice and clinical voice lab from 1995 to 1 998, Demographic data reveal most patients to range in age from 16 to 91 wi th a dominant clustering for ages 50 to 70. Gender distribution reveals mal es slightly exceed females in this sample. Data regarding etiology type are collected in great detail, revealing that disease and surgery involving th e chest contribute the greatest to the overall number in this study and tha t anterior approach to cervical spine surgery contributes as much as thyroi d surgery. General outcomes of the patients are reviewed. A small group (n = 25) of patients who had pretreatment and posttreatment data available rev ealed statistically significant differences between voice outcomes for pati ents who were treated with medialization and for those treated with therapy . Patients receiving therapy had less severe symptoms pretreatment, while g reater gains pretreatment to posttreatment were shown for those who had sur gical medialization.