Vocal Fold Paresis: Controversies and Consensus

불완전 성대 마비: 논란과 합의

  • Kim, Tae-Wook (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Son, Young-Ik (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 김태욱 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 손영익 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실)
  • Received : 2010.06.06
  • Published : 2010.06.15

Abstract

Mild vocal fold hypomobility is a common finding of which clinical significance is incompletely understood. Recently, electrophysiologic investigations have shown that vocal fold hypomobility is a continuum of neurogenic dysfunction ; partial denervation (paresis), complete denervation (paralysis), and variable degrees and patterns of reinnervation. Despite a sound pathophysiological basis for its existence, interest in and acceptance of the diagnosis of vocal fold paresis is relatively recent. Vocal fold paresis may be a relatively common and often overlooked condition that can be difficult to diagnose since laryngoscopy does not reliably distinguish innocent laryngeal asymmetry from hypomobility caused by paresis. Although not entirely free from error, laryngeal electromyography seems to hold more promise as a means of reliable diagnosis than laryngoscopy, and should be employed systematically in the evaluation of suspected paresis. The means to help most patients with paresis already exists in the repertoire of interventions developed to treat paralysis. However, since the vocal fold retains substantial movement, more conservative treatment strategy is recommended as a first line of treatment. The authors reviewed the representative reports of vocal fold paresis and summarized the controversies and consensus regarding the vocal fold paresis.

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