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Analysis of laryngoscopic features in patients with unilateral vocal fold paresis
Author(s) -
Woo Peak,
Parasher Arjun K.,
Isseroff Tova,
Richards Amanda,
Sivak Mark
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25790
Subject(s) - paresis , medicine , laryngoscopy , vocal folds , glottis , phonation , electromyography , larynx , stroboscope , electroglottograph , anatomy , audiology , surgery , physical medicine and rehabilitation , intubation , electrical engineering , engineering
Objectives/Hypothesis The diagnosis of paresis in patients with vocal fold motion impairment remains a challenge. More than 27 clinical parameters have been cited that may signify paresis. We hypothesize that some features are more significant than others. Study Design Prospective case series. Methods Two laryngologists rated laryngoscopy findings in 19 patients suspected of paresis. The diagnosis was confirmed with laryngeal electromyography. A standard set of 27 ratings was used for each examination that included movement, laryngeal configuration, and stroboscopy signs. A Fisher exact test was completed for each measure. A kappa coefficient was calculated for effectiveness in predicting the laterality of paresis. Results Left‐sided vocal fold paresis (n = 13) was significantly associated with ipsilateral axis deviation, thinner vocal fold, bowing, reduced movement, reduced kinesis, and phase lag ( P < .05). Right‐sided vocal fold paresis (n = 6) was significantly associated with ipsilateral shorter vocal fold, axis deviation, reduced movement, and reduced kinesis ( P < .05). Using these key parameters, the senior author was accurately able to diagnose the side of paresis in 89.5% of cases for a kappa coefficient of 0.78. Conclusions Of the multiple features on laryngoscopy, glottic configuration, ipsilateral thin vocal fold, vocal fold bowing, reduced movement, reduced kinesis, and phase lag were more likely to be associated with vocal fold paresis. Level of Evidence 4 Laryngoscope , 126:1831–1836, 2016