Diagnosis of vocal fold paresis: current opinion and practice. Academic Article uri icon

Overview

abstract

  • OBJECTIVES/HYPOTHESIS: No accepted standard exists for the diagnosis of vocal fold paresis (VFP). Laryngeal specialists are surveyed to establish expert opinion on diagnostic methodology and criteria. STUDY DESIGN: Cross-sectional survey. METHODS: Questionnaires were distributed at laryngology conferences in fall 2013. Responses were collated anonymously and subjected to cross-tabulated data analysis. RESULTS: Fifty-eight responses completed by posttraining physicians whose practice focused in laryngology ≥ 75% were analyzed. One (1.7%) relied principally on laryngeal electromyography, one (1.7%) on history, 10 (17%) on laryngoscopy, and 42 (72%) on strobovideolaryngoscopy for diagnosis. Only 12 (21%) performed laryngeal electromyography on > 50% of vocal fold paresis patients. Laryngeal electromyography sensitivity was considered moderate (61 ± 3.7%, σ = 28). Laryngoscopic/stroboscopic findings considered to have the strongest positive predictive value for VFP were slow/sluggish vocal fold motion (75 ± 3.0%, σ = 23), decreased adduction (67 ± 3.5%, σ = 27), decreased abduction (65 ± 3.4%, σ = 26), and decreased vocal fold tone (61 ± 3.5%, σ = 26). Asymmetric mucosal wave amplitude (52 ± 4.2%, σ = 32), asymmetric mucosal wave phase (60 ± 4.1%, σ = 31), hemilaryngeal atrophy (60 ± 4.0%, σ = 31), and asymmetric mucosal wave frequency (49 ± 4.0%, σ = 30) generated greatest disagreement. CONCLUSIONS: Surveyed expert laryngologists diagnose vocal fold paresis predominantly on stroboscopic examination. Gross motion abnormalities had the highest positive predictive value. Laryngeal electromyography was infrequently used to assess for vocal fold paresis.

publication date

  • November 13, 2014

Research

keywords

  • Electromyography
  • Laryngoscopy
  • Stroboscopy
  • Surveys and Questionnaires
  • Vocal Cord Paralysis

Identity

Scopus Document Identifier

  • 84925424675

Digital Object Identifier (DOI)

  • 10.1002/lary.25004

PubMed ID

  • 25394306

Additional Document Info

volume

  • 125

issue

  • 4