Vocal fold paresis: a review of clinical presentation, differential diagnosis, and prognostic indicators

  title={Vocal fold paresis: a review of clinical presentation, differential diagnosis, and prognostic indicators},
  author={Mausumi N Syamal and Michael S. Benninger},
  journal={Current Opinion in Otolaryngology \& Head and Neck Surgery},
Purpose of reviewVocal fold paresis is a complex, controversial, and unique clinical entity. Guidance in assessing and evaluating these patients is provided in this comprehensive review of the current literature discussing the varying clinical presentation, the broad differential and general prognosis. Recent findingsPatients with vocal fold paresis can present with elements of hyperfunction, which can often mask an underlying paresis. As such, repetitive phonatory tasks and videostroboscopic… 

Vocal fold paresis - a debilitating and underdiagnosed condition.

This study shows that laryngeal electromyography is an important diagnostic tool and patients with persisting dysphonia and apparently normal vocal fold movement, who fail to respond to appropriate speech therapy, should be investigated for a diagnosis of vocal fold paresis.

Vocal fold paresis: Medical specialists’ opinions on standard diagnostics and laryngeal findings

The laryngology experts in Europe rely on LEMG for diagnosis of VFP like the US American experts, but paradoxically only a minority uses L EMG frequently, and motion abnormities were considered to have the best predictive value for the diagnosis ofVFP.

Comparison of Clinical Characteristics Between Patients With Different Causes of Vocal Cord Immobility

In patients with suspected vocal cord palsy, impaired high pitched ‘e’ sound and aspiration symptoms were more common in group with neurogenic cause of VCI, and hoarseness was more frequent in subjects with recurrent laryngeal neuropathy.

Vocal Fold Paresis and Voice Outcomes following Vocal Fold Mass Excision.

Vocal Cord Palsies Missed by Transcutaneous Laryngeal Ultrasound (TLUSG): Do They Experience Worse Outcomes?

The VCP missed by TLUSG had a milder course of disease and early recovery of VC function and non-permanent palsy were expected.

The Prevalence of Dysphonia and Dysphagia in Patients with Vitamin D Deficiency.

Is Computerized Dynamic Posturography Analysis in Dysphonic Patients Different after Vocal Rehabilitation Treatment? A Longitudinal Study

The results of this study indicate that modifications of voice production techniques lead to objective and measurable postural changes in dynamic posturographic analysis, and confirmed an improvement in the postural performance of dysphonic patients after a successful voice treatment.

Assessment of vocal cord movement by ultrasound in the ICU

LLU can be used to evaluate arytenoid cartilage activity in ICUs, and the results are highly correlated with the diagnosis of nasal fiber-optic endoscopy.

Immediate and partial neural dysfunction after thyroid and parathyroid surgery: Need for recognition, laryngeal exam, and early treatment

A panel to define the terms “immediate vocal fold paralysis’ and “partial neural dysfunction” and to provide clinical consensus statements based on review of the literature, integrated with expert opinion of the group.



Vocal fold paresis: evidence and controversies

Vocal fold paresis is probably a significant source of vocal disability, especially among cases that have eluded straightforward diagnosis, and an accurate assessment of its clinical impact, patterns of dysfunction, natural history and relationship to other pathologies depends on diagnostic rigor and accuracy and is still evolving.

Mild vocal fold paresis: understanding clinical presentation and electromyographic findings.

Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice.

Vocal fold paresis

A retrospective review of the records of 50 consecutive adult patients with VFP found that VFP appears to be underdiagnosed because many VFP patients have compensatory hyperkinetic disorders at presentation.

Laryngeal myasthenia gravis: report of 40 cases.

The prevalence of undiagnosed thyroid disease in patients with symptomatic vocal fold paresis.

Laryngeal asymmetry on indirect laryngoscopy in a symptomatic patient should be evaluated with electromyography.

  • K. Altman
  • Medicine
    Archives of otolaryngology--head & neck surgery
  • 2005
Controversy remains regarding its limitations, principally whether the use of LEMG ultimately alters the treatment of such a patient, and there is no clear consensus on the choice and timing of intervention to improve the patient’s voice.

An old flame reignites: vagal neuropathy secondary to neurosyphilis.

Vocal Fold Paresis of Charcot-Marie-Tooth Disease

It is concluded that CMT does not spare the cranial nerves, as has been previously thought, and vocal fold paresis is not restricted to CMT type 2 and should not be considered a hallmark of that category.

Muscle Tension Dysphonia as a Sign of Underlying Glottal Insufficiency

Clinicians should be aware that compensatory hyperkinetic laryngeal behaviors may mask an underlying organic condition and abnormal MTPs are common in persons with underlying glottal insufficiency.