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Vocal motor control and central auditory impairments in unilateral vocal fold paralysis
Author(s) -
Naunheim Molly L.,
Yung Katherine C.,
Schneider Sarah L.,
HendersonSabes Jennifer,
Kothare Hardik,
Mizuiri Danielle,
Klein David J.,
Houde John F.,
Nagarajan Srikantan S.,
Cheung Steven W.
Publication year - 2019
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.27680
Subject(s) - audiology , motor control , medicine , spasmodic dysphonia , auditory feedback , physical medicine and rehabilitation , psychology , neuroscience , anesthesia , botulinum toxin
Objectives To evaluate differences in vocal motor control and central auditory processing between treated unilateral vocal fold paralysis (UVFP) and healthy control cohorts. Study Design Cross‐sectional. Methods Ten UVFP study patients treated by type I thyroplasty with stable voices were compared to 12 control subjects for vocal motor control using a pitch perturbation response task and central auditory processing performance using a battery of complex sound intelligibility assays that included adverse temporal and noise conditions. Standard clinical evaluations of voice production and peripheral audiometric sensitivity were performed. Results Vocal motor control was impaired in treated UVFP. The UVFP cohort exhibited a 32.5% reduction in the instantaneous, subconscious compensatory response to pitch feedback perturbation in the interval between 150 ms and 550 ms following onset ( P < 0.0001, linear mixed effects model). This impairment cannot simply be ascribed to vocal motor capacity insufficiency in the UVFP cohort because both cohorts demonstrated comparable functional capacity to perform the vocal motor task. The UVFP cohort also showed greater propensity for central auditory processing impairment ( P < 0.05), notably for temporal compression and added noise challenges. Conclusion Combined central vocal motor control and auditory processing impairments in treated UVFP highlight reciprocal interdependency of sensory and motor systems. This pilot study suggests that peripheral motor impairment of the larynx can degrade central auditory processing, which in turn may contribute to vocal motor control impairment. A more complete restoration communicative function in UVFP will require deeper understanding of sensory, motor, and sensorimotor aspects of the human communication loop. Level of Evidence 3b Laryngoscope , 129:2112–2117, 2019