Prevalence of aspiration and laryngeal penetration in patients with unilateral vocal fold motion impairment

The adverse consequences of aspiration in regard to patient health and qual ity of life are well documented. It is generally accepted that the probabil ity of aspiration is increased in patients with unilateral vocal fold motio n impairment, however, the incidence and proposed mechanism of aspiration v ary depending on the reported series. We reviewed the cine or video pharyng oesophagographic findings in patients with documented unilateral vocal fold motion impairment, identified through the Johns Hopkins Hospital Swallowin g Center database, to determine the prevalence and cause of aspiration and laryngeal penetration. Aspiration and laryngeal penetration were identified in 38% and 12% of patients, respectively. Aspiration resulted from impaire d airway protection, not from esophageal obstruction with laryngeal "spill- over." The number and degree of impairments directly correlated with probab ility of aspiration. Obstruction potentiated the likelihood of aspiration. Video pharyngoesophagography accurately identifies patients at risk for asp iration.