Open AccessMOTENA GIBLJIVOST GLASILK - DIAGNOSTIČNI POSTOPKI IN ZDRAVLJENJE 2. del
Author(s) -
Karlo Pintarić,
Irena Hočevar Boltežar
Publication year - 2015
Publication title -
zdravniški vestnik
Language(s) - English
Resource type - Journals
eISSN - 1581-0224
pISSN - 1318-0347
DOI - 10.6016/zdravvestn.1334
Subject(s) - medicine , swallowing , paresis , phonation , vocal folds , breathing , paralysis , rehabilitation , laryngoscopy , vocal fold paralysis , reinnervation , surgery , physical medicine and rehabilitation , anesthesia , larynx , audiology , physical therapy , intubation
Paresis or paralysis of one or both vocal cords affects phonation, swallowing and breathing. The major cause for reduced mobility or even immobility is innervation damage, less often mechanical disorder.The main procedures in the diagnostics of disordered vocal fold mobility are indirect laryngoscopy and videoendostroboscopy. Different imaging techniques (especially computerized tomography) are of great value in searching for a cause of the impaired mobility.In unilateral vocal fold immobility, the treatment is focused on the improvement of voice quality and the prevention of aspiration during swallowing. In bilateral paralysis, it is crucial to find a balance between effective breathing and sufficient voice quality. The treatment of unilateral paralysis is started with voice therapy and swallowing rehabilitation. If these procedures are not enough surgical treatment for the medialization of the paralyzed vocal fold is applied. In the case of breathing difficulties in bilateral vocal fold immobility there is a possibility of surgical lateralization of one or both folds or a surgical excision of a part or the entire vocal fold. Surgical reinnervation, functional electrostimulation of certain laryngeal muscles and gene therapy are developing treatment modalities.