Search Our Scientific Publications & Authors

JAMA Otolaryngol Head Neck Surg 2021 Jun 10. Epub 2021 Jun 10.

School of Communication Sciences and Disorders, McGill University, Montreal, Canada.

Importance: Vocal fold paralysis (VFP) results from the disruption of neural motor outputs to laryngeal muscles. Children with VFP manifest various degrees of difficulties in phonation, breathing, and swallowing. Although the etiologic characteristics and symptoms of VFP are well established in adults, corresponding clinical profiles are notably different in children. Read More

Eur Arch Otorhinolaryngol 2021 Jun 9. Epub 2021 Jun 9.

Audiology and Phoniatric Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, Nadarzyn, 05-830, Warsaw, Poland.

Purpose: The objective was to investigate whether a patient's preoperative test results can predict the need for future reoperation in unilateral vocal fold paralysis (UVFP).

Methods: A single-centre retrospective study was performed. The study group consisted of 18 patients with UVFP who had been treated with injection laryngoplasty but who required further treatment and were augmentated again within 36 months. Read More

Laryngoscope 2021 Jun 9. Epub 2021 Jun 9.

Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, U.S.A.

Objectives: Laryngeal vibratory asymmetry occurring with paresis may result in a perceptually normal or abnormal voice. The present study aims to determine the relationships between the degree of vibratory asymmetry, acoustic measures, and perception of sound stimuli.

Study Design: Animal Model of Voice Production, Perceptual Analysis of Voice. Read More

J Med Internet Res 2021 Jun 8;23(6):e25247. Epub 2021 Jun 8.

Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Background: Dysphonia influences the quality of life by interfering with communication. However, a laryngoscopic examination is expensive and not readily accessible in primary care units. Experienced laryngologists are required to achieve an accurate diagnosis. Read More

Curr Otorhinolaryngol Rep 2020 Dec 3;8(4):395-401. Epub 2020 Sep 3.

Vanderbilt University Medical Center, Department of Otolaryngology, Head & Neck Surgery, Nashville, TN, USA.

Purpose Of Review: Present the state-of-the-art overview of laryngeal pacing for treatment of bilateral vocal fold paralysis. A minimally invasive unilateral pacing system and a fully implantable bilateral pacing system are currently in clinical trials. The relative advantages and disadvantages of each are discussed. Read More

Diagnostics (Basel) 2021 May 20;11(5). Epub 2021 May 20.

School of Medicine, Chang Gung University, 259 Wen-Hwa 1st Road, Taoyuan 333, Taiwan.

(1) Background: severe weight loss was reported to be related to unilateral vocal fold paralysis (UVFP) after esophagectomy and could thus impair survival. Concomitant radical lymph node dissection along the recurrent laryngeal nerve during esophageal cancer surgery is controversial, as it might induce UVFP. Early intervention for esophagectomy-related UVFP by administering intracordal injections of temporal agents has recently become popular. Read More

Otolaryngol Head Neck Surg 2021 Jun 1:1945998211015174. Epub 2021 Jun 1.

Department of Otolaryngology-Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, Chiayi.

Objective: To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP).

Study Design: Population-based retrospective cohort study.

Setting: Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan. Read More

Muscle Nerve 2021 May 7. Epub 2021 May 7.

Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Introduction/aims: Temporary vocal fold injection (VFI) is a common treatment for acute and subacute vocal fold paralysis (VFP). Laryngeal electromyography (LEMG) is useful for diagnosing neurogenic causes of VFP. This study evaluated whether the presence of VFI material prevents interpretation of LEMG in patients with acute and subacute VFP. Read More

Laryngoscope 2021 May 6. Epub 2021 May 6.

Division of Pediatric Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, U.S.A.

Objectives/hypothesis: We report a posterior laryngeal rating system and measures of voice disability in pediatric patients undergoing phonosurgery for vocal fold paralysis. Posterior glottic deficiency may account for persistent voice disability.

Study Design: Retrospective Study. Read More

Dysphagia 2021 May 3. Epub 2021 May 3.

Department of Otolaryngology; Head & Neck Surgery, Monash Health, Melbourne, Australia.

The use of narrow band imaging (NBI) during flexible endoscopic evaluation of swallowing (FEES) is recognised as an emerging technology to improve the contrast of the test fluid during endoscopic dysphagia evaluation. This study tested the hypothesis that the use of NBI in FEES would improve the detection of laryngeal penetration and aspiration in patients with unilateral vocal fold paralysis/paresis (UVFP), a typically difficult population in which to detect the presence of aspiration with FEES. Twenty-one consecutive outpatients with UVFP were evaluated with FEES using white light (WL) and NBI under 150 test conditions (75 WL & 75 NBI). Read More

Auris Nasus Larynx 2021 Apr 22. Epub 2021 Apr 22.

Department of Otorhinolaryngology-Head and Neck Surgery, National University Malaysia Medical Center, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, Kuala Lumpur 56000, Malaysia. Electronic address:

Objective: Laryngeal electromyography (LEMG) is used to confirm neuropathy; traditionally, it is evaluated qualitatively. This study aimed to develop normative values for the thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex by determining the mean turns (MT) and mean amplitudes (MA) using the opposite normal mobile vocal fold in unilateral vocal fold paralysis (VFP). This study also compared the MT and MA of the paralyzed vocal fold with that of the normal side and analyzed their correlations. Read More

Laryngoscope 2021 Apr 2. Epub 2021 Apr 2.

Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria.

Objective: Selective electrical surface stimulation (SES) of the larynx is not yet routinely considered therapy option in treatment of unilateral vocal fold paralysis (UVFP). Goal of this monocentric feasibility study was to provide systematic data on applicability of SES of intrinsic laryngeal muscles in UVFP under consideration of sensitivity and discomfort thresholds and nonselective side effects.

Methods: Thirty-two UVFP patients were included in the study. Read More

Clin Otolaryngol 2021 Mar 31. Epub 2021 Mar 31.

Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Objective: Hyaluronic acid (HA) can be degraded over time. However, persistence of the effects after injection laryngoplasty (IL) for unilateral vocal fold paralysis (UVFP), longer than expected from HA longevity, has been observed. The purpose of the study was to develop a methodology with clinical utility for objective evaluation of the temporal change in HA volume after IL using artificial intelligence (AI)-based ultrasonic assessment. Read More

J Voice 2021 Mar 27. Epub 2021 Mar 27.

Department of Otolaryngology Head and Neck Surgery, Nanjing Tongren Hospital, School of Medicine, Southeast University, Nanjing, China. Electronic address:

Purpose: To investigate the therapeutic effect of the stromal vascular fraction gel (SVF gel) in unilateral vocal fold paralysis.

Methods: A retrospective study was performed on 22 patients who underwent SVF gel autotransplantation for unilateral vocal fold paralysis between June 2017 and December 2018. Fat was removed from the medial thigh under anesthesia and the SVF gel was prepared using standard techniques and injected using a suspension microlaryngoscopy. Read More

Dysphagia 2021 Mar 17. Epub 2021 Mar 17.

Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.

The association between swallowing function and cough strength in patients with unilateral vocal fold paralysis (UVFP) is unknown. We evaluated the relationship between voluntary cough strength and dysphagia among patients with UVFP (UVFP group) by comparing their data with that of corresponding healthy participants (healthy control [HC] group) in a prospective observational study. From February 1st, 2018 to March 30th, 2019, we recruited patients with a voice disorder due to UVFP, who were referred to our university hospital. Read More

BMJ Case Rep 2021 Mar 15;14(3). Epub 2021 Mar 15.

Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

A 67-year-old man presented with progressive diplopia. On evaluation, he was noted to have bilateral palsies of cranial nerves III, IV and VI as well as a unilateral right true vocal fold paralysis. CT and MRI studies demonstrated a T2-bright left ethmoid mass with no evidence of bony erosion. Read More

Eur Arch Otorhinolaryngol 2021 Jul 10;278(7):2387-2395. Epub 2021 Mar 10.

Department of Otorhinolaryngology, Division of Phoniatrics and Speech Language Therapy, Medical University of Vienna/Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Purpose: In clinical practice, laryngo(strobo)scopy (LS) is still mainly used for diagnostics and management of unilateral vocal fold paralysis (UFVP), although only laryngeal electromyography (LEMG) can provide information on causes of vocal fold immobility, especially on possible synkinetic reinnervation after recurrent laryngeal nerve (RLN) injury. The goal of this retrospective study was the evaluation whether signs of synkinetic reinnervation in LS can be objectified in comparison to LEMG data.

Methods: Between 1/2015 and 2/2018, 50 patients with laryngostroboscopically suspected UVFP received routine LEMG examination. Read More

J Laryngol Otol 2021 Mar 2;135(3):255-258. Epub 2021 Mar 2.

Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore.

Background: There is a paucity of Asian-based data regarding the diagnostic yield of computed tomography imaging in the initial assessment of idiopathic unilateral vocal fold palsy.

Objectives: To investigate the diagnostic yield of computed tomography in idiopathic unilateral vocal fold palsy cases in an Asian tertiary hospital, and to determine the causative pathologies and positive predictive factors.

Method: A retrospective chart review was conducted of patients (between 2010 and 2018) with a clinical diagnosis of idiopathic unilateral vocal fold palsy who underwent contrast-enhanced computed tomography of the neck and chest at Tan Tock Seng Hospital, Singapore. Read More

J Laryngol Otol 2021 Mar 26;135(3):264-268. Epub 2021 Feb 26.

Department of Surgery, Harvard Medical School, Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston.

Objectives: This study aimed to report the pre- and post-operative laryngeal endoscopic findings in patients referred by non-otolaryngologists who are undergoing thyroid and/or parathyroid surgery, and to determine the number and nature of referrals before and after the release of the clinical practice guideline for improving voice outcomes after thyroid surgery.

Methods: This retrospective cohort study, conducted at a tertiary care academic hospital, comprised adult patients referred by the endocrine surgery service for laryngoscopy from 2007 to 2018 (n = 166). Data regarding patient demographics, reason for referral and endoscopic findings were recorded. Read More

Eur Rev Med Pharmacol Sci 2021 Feb;25(3):1177-1184

Department of Sensorial Organs, Sapienza University of Rome, Rome, Italy.

Objective: Thyroidectomy is the primary cause of unilateral vocal fold paralysis (UVFP). A delay in rehabilitation may cause dysfunctional phenomena and worsen dysphonia. The main aim is to investigate the impact of early Speech Therapy (ST) on voice recovery in UVFP post-thyroidectomy and propose an appropriate treatment schedule. Read More

J Laryngol Otol 2021 Feb 17;135(2):159-167. Epub 2021 Feb 17.

Department of Laryngology, Dr Jayakumar's Institute of Laryngology, Trivandrum, India.

Objective: The aim of this study was to establish arytenoid asymmetry as a pre-operative predictive parameter for arytenoid adduction surgery in unilateral vocal fold paralysis and thereafter identify the most predictive parameter for arytenoid adduction among the established parameters.

Methods: A retrospective comparative study was undertaken. The 'arytenoid asymmetry angle' formed between skewed 'glottic' and 'interarytenoid' axes (traced along the plane of closure of the membranous and cartilaginous glottis, respectively) was quantified in pre-operative laryngoscopic images of 85 adults with unilateral vocal fold paralysis who underwent either type 1 thyroplasty (group 1) or type 1 thyroplasty with arytenoid adduction (group 2). Read More

Otolaryngol Head Neck Surg 2021 Feb 16:194599821989608. Epub 2021 Feb 16.

Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.

Objectives: (1) Demonstrate true vocal fold (TVF) tracking software (AGATI [Automated Glottic Action Tracking by artificial Intelligence]) as a quantitative assessment of unilateral vocal fold paralysis (UVFP) in a large patient cohort. (2) Correlate patient-reported metrics with AGATI measurements of TVF anterior glottic angles, before and after procedural intervention.

Study Design: Retrospective cohort study. Read More

Medicine (Baltimore) 2021 Jan;100(3):e24374

Department of Orthopedics, Zhangqiu People's Hospital, Jinan.

Rationale: Vocal fold paralysis and cauda equina syndrome are very rare neurologic deficits. This report describes the case of a patient who simultaneously developed both after uneventful spinal-epidural anesthesia with 0.5% hyperbaric bupivacaine. Read More

medRxiv 2021 Jan 18. Epub 2021 Jan 18.

Objectives: To detect unilateral vocal fold paralysis (UVFP) from voice recordings using an explainable model of machine learning.

Study Design: Case series - retrospective with a control group.

Methods: Patients with confirmed UVFP through endoscopic examination (N=77) and controls with normal voices matched for age and sex (N=77) were included. Read More

Braz J Otorhinolaryngol 2020 Dec 26. Epub 2020 Dec 26.

Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Introduction: Revision framework surgeries might be required for unilateral vocal fold paralyses. However, outcomes and indications of revision surgeries have not been adequately documented. For a better understanding of indications for the procedure and to help in achieving better vocal outcomes, we performed a retrospective chart review of patients who underwent revision framework surgeries for unilateral vocal fold paralysis. Read More

Ann Otol Rhinol Laryngol 2021 Jan 8:3489420987201. Epub 2021 Jan 8.

Head and Neck Surgery, Tina and Rick Caruso Department of Otolaryngology, University of Southern California, Los Angeles, CA, USA.

Objective: The purpose of this study was to evaluate the incidence of laryngeal pathology found during bedside flexible endoscopic evaluation of swallowing (FEES) in a community hospital.

Methods: A retrospective study among patients who underwent a bedside FEES examination from May 2018 to May 2019. Criteria to perform a bedside FEES exam were patients who were identified through nursing screening swallowing evaluation and failed a bedside clinical evaluation of swallowing by a speech language pathologist. Read More

J Voice 2020 Dec 31. Epub 2020 Dec 31.

Department of Voice, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China. Electronic address:

Objective: The diffusion characteristics of water molecules were measured in the vocal folds of canines exhibiting unilateral vocal fold paralysis and unilateral cricoarytenoid joint dislocation. These characteristics were used in conjunction with a histological examination of the microstructural changes of vocal fold muscle fibers to explore the feasibility of diffusion tensor imaging (DTI) in distinguishing unilateral vocal fold paralysis and unilateral cricoarytenoid joint dislocation as well as evaluating microstructural changes.

Methods: Ten beagles were randomly divided into three groups: four in the unilateral vocal fold paralysis group, four in the unilateral cricoarytenoid joint dislocation group, and two in the normal group. Read More

Acta Otorhinolaryngol Ital 2020 Dec 29. Epub 2020 Dec 29.

IRCCS Ospedale Policlinico San Martino, Genoa, Italy.

Objective: Development of transnasal fiberoptic laryngoscopy, integration of an operative channel (OC), the advent of high-definition television imaging, with improvements in laser technology, cleared the way for office-based laryngology. Three treatment categories can be identified: bioendoscopy-guided biopsy; laryngeal injection; laser-assisted surgery.

Methods: 26 patients underwent OBPs at the Otolaryngology Clinic of IRCCS Policlinico San Martino, Genoa, Italy. Read More

Clin Otolaryngol 2021 May 27;46(3):530-537. Epub 2021 Jan 27.

Department of Otorhinolaryngology, Division of Phoniatrics-Logopedics, Medical University of Vienna, Vienna, Austria.

Objectives: The goal of the retrospective study was to investigate the 3-month-outcome after treatment of patients with early unilateral vocal fold paralysis (UVFP) with either standard voice therapy (VT) or selective electrical stimulation of the larynx (SES).

Design: Non-randomised retrospective study.

Setting: 1519 patients who underwent thyroid surgery between 2015 and 2018 were analysed according vocal fold mobility; UVFP patients were treated either by VT or SES. Read More

Laryngoscope 2021 05 25;131(5):E1624-E1632. Epub 2020 Dec 25.

Department of Ear-Nose-Throat, Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.

Objectives/hypothesis: Injection laryngoplasty of materials for unilateral vocal-fold paralysis has shown various results regarding the long-term stability of the injected material. We evaluated a fibrin-gel based cell suspension with autologous chondrocytes in-vitro and in-vivo as long-term-stable vocal-fold augmentation material in an animal model.

Study Design: This study compises an in vitro cell-culture part as well as an in vivo animal study with New Zealand White Rabbits. Read More