Abstract
Early management of unilateral vocal fold paralysis (UVFP) includes behavioral, medical, and surgical interventions in the first 6 months after the onset of paralysis. There is no universal algorithm for the early management of UVFP. The patient’s symptoms and expectations shape treatment choices. The most common, and very effective, treatment employed during acute management of glottal incompetence from UVFP is temporary injection laryngoplasty. Although patients often most appreciate the voice quality improvement after vocal fold augmentation, the improved swallowing function and cough effectiveness are most important. In patients who have minimal or no symptomatic repercussions from their UVFP, observation is a reasonable option. Early treatment of UVFP is driven by the patient’s symptoms (swallowing difficulties, voice requirements), underlying medical comorbidities, and their own desires for treatment. Understanding and discussing the expected natural evolution of UVFP is critical in the decision-making process. We are at the dawn of developing new treatments to restore dynamic vocal fold motion by manipulating the microenvironment surrounding injured nerves. Although these treatments are in their infancy, the concept of advancing treatment of UVFP beyond traditional static treatments is exciting.
Keywords
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Abbreviations
- FEES:
-
Fiberoptic endoscopic evaluation of swallowing
- LEMG:
-
Laryngeal electromyography
- MBS:
-
Modified barium swallow
- RLN:
-
Recurrent laryngeal nerve
- SLP:
-
Superficial layer of the lamina propria
- UVFP:
-
Unilateral vocal fold paralysis
- VFI:
-
Vocal fold injection
- VFP:
-
Vocal fold paralysis
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Leclerc, AA., Smith, L.J. (2019). Early Management of Unilateral Vocal Fold Paralysis. In: Amin, M., Johns, M. (eds) Decision Making in Vocal Fold Paralysis. Springer, Cham. https://doi.org/10.1007/978-3-030-23475-1_3
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