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The impact of cricothyroid involvement on adductor recovery in unilateral vocal fold paralysis
Author(s) -
Fang TuanJen,
Chuang HsiuFeng,
Chiang HuiChen,
Pei YuCheng
Publication year - 2020
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.27868
Subject(s) - vocal fold paralysis , medicine , superior laryngeal nerve , stroboscope , spasmodic dysphonia , electromyography , paralysis , lesion , cohort , surgery , anesthesia , botulinum toxin , larynx , physical medicine and rehabilitation , electrical engineering , engineering
Objectives/Hypothesis Wide variation in postinjury functional recovery is a hallmark of unilateral vocal fold paralysis (UVFP), ranging from zero to full recovery. The present study examined the impact of cricothyroid (CT) muscle involvement on recovery using quantitative laryngeal electromyography (LEMG) of the thyroarytenoid–lateral cricoarytenoid (TA‐LCA) muscle complex at multiple times postinjury. Study Design Prospective cohort study in a medical center. Methods Eighty‐one patients with UVFP (37 males and 44 females) received an initial assessment of quantitative LEMG, stroboscope, acoustic voice analysis and 36‐Item Short Form Survey quality‐of‐life questionnaire at 3 to 6 months after UVFP onset and a follow‐up assessment at 12 months after UVFP onset. Results The initial and follow‐up assessments were performed at 4.3 ± 1.9 and 12.5 ± 1.3 months after UVFP onset, respectively. The peak turn frequency of the TA‐LCA muscle complex on the lesion side was improved at the follow‐up (470 ± 294 Hz) compared with the initial assessment (300 ± 204 Hz) ( P < .001). Patients were also divided into two groups with (n = 27) and without (n = 54) CT involvement, respectively. TA‐LCA muscle complex turn frequency improved in patients without CT involvement (from 277 ± 198 to 511 ± 301 Hz; P < .001), but not in those with CT involvement (from 345 ± 211 to 386 ± 265 Hz; P = .46). Seventy‐one of all patients received early intervention with intracordal hyaluronate injection, showing similar therapeutic effects in those with and without CT involvement. Conclusions Acute UVFP with combined TA‐LCA muscle complex and CT muscle involvement has a poor prognosis, with poorer recovery of TA‐LCA muscle complex recruitment. Early interventions should be considered in patients with UVFP with CT involvement. Level of Evidence 2 Laryngoscope , 130:139–145, 2020