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Head Neck. 2019 Jul;41(7):2389-2397. doi: 10.1002/hed.25715. Epub 2019 Feb 27.

High-resolution manometry and swallow outcomes after vocal fold injection medialization for unilateral vocal fold paralysis/paresis.

Author information

1
Department of Surgery, University of Wisconsin, Madison, Wisconsin.
2
Department of Otolaryngology, New York University School of Medicine, New York, New York.

Abstract

BACKGROUND:

Injection medialization is performed to improve glottic closure, thereby airway protection. Overall objective to determine if unilateral injection medialization changes glottal area with concomitant adjustments in penetration/aspiration scale (PAS) scores and pharyngeal high-resolution manometry (HRM) parameters.

METHODS:

Enrolled 17 adults with unilateral vocal fold paralysis/paresis and aspiration/penetration. Fiberoptic endoscopic evaluation of swallowing and pharyngeal HRM completed at (1) baseline (within 1 week before injection), (2) postinjection (within 1 week post injection), and (3) 1-month postinjection. Comparisons between time points for PAS scores, glottal area, pharyngeal pressure, and timing.

RESULTS:

No significant differences in normalized glottal area. No significant differences in PAS scores, for any consistency. Significantly increased rate of mesopharynx pressure rise and maximum pressure at 1 month postinjection (P = .01 and .02, respectively) compared to baseline. Significant decrease in mesopharynx integral from baseline to 1 week postoperative (P = .03).

CONCLUSION:

Findings suggest unilateral vocal fold injection medialization had limited effect on swallow function.

KEYWORDS:

dysphagia; medialization; pharyngeal high-resolution manometry; vocal fold paralysis

PMID:
30811725
DOI:
10.1002/hed.25715

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