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Vocal fold paresis accompanying vocal fold polyps

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate patients with vocal fold polyps using laryngeal electromyography (LEMG) for the presence of vocal fold paresis and to compare transnasal fiberoptic and rigid stroboscopic findings between polyp patients with normal LEMG and with vocal fold paresis. Thirty-five patients with a vocal fold polyp underwent transnasal fiberoptic laryngoscopy, rigid laryngostroboscopy, and LEMG. The findings were compared between the LEMG-confirmed vocal fold paresis patients and the normal LEMG patients. LEMG resulted in a diagnosis of unilateral or bilateral vocal fold paresis in 17 of 35 patients (48.6 %). More men than women with vocal fold polyps had vocal fold paresis (p < 0.05). The vocal fold paresis group had higher presence of axial rotation and hypomobility of vocal folds, higher asymmetry of vertical height of vocal folds, and less presence of longitudinal stretch of vocal folds (p < 0.05). Medial–lateral compression of the false vocal folds and anterior–posterior approximation of the larynx did not show any difference between the groups. No significant difference was found in vibratory wave characteristics between the groups through rigid laryngostroboscopy. Vocal fold paresis was present in almost half of the patients with vocal fold polyps. Paresis can only be accurately diagnosed with LEMG. Transnasal fiberoptic laryngoscopic examination is helpful to recognize vocal fold paresis in vocal fold polyp patients, while stroboscopic examination is not useful to identify it in vocal fold polyp patients.

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References

  1. Dikkers FG, Nikkels PGJ (1995) Benign lesions of the vocal folds: histopathology and phonotrauma. Ann Otol Rhinol Laryngol 104:698–703

    Article  CAS  PubMed  Google Scholar 

  2. Marcotullio D, Magliulo G, Pietrunti S, Suriano M (2002) Exudative laryngeal diseases of Reinke’s space: a clinicohistopathological framing. J Otolaryngol 31:376–380

    Article  PubMed  Google Scholar 

  3. Koufman JA, Amin MR, Panetti M (2000) Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Otolaryngol Head Neck Surg 123:385–388

    Article  CAS  PubMed  Google Scholar 

  4. Johns MM (2003) Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. Curr Opin Otolaryngol Head Neck Surg 11:456–461

    Article  PubMed  Google Scholar 

  5. Martins RH, Defaveri J, Domingues MA, de Albuquerque e Silva R (2011) Vocal polyps: clinical, morphological, and immunohistochemical aspects. J Voice 25(1):98–106

    Article  PubMed  Google Scholar 

  6. Chung JH, Tae K, Lee YS, Jeong JH, Cho SH, Kim KR, Park CW, Han DS (2009) The significance of laryngopharyngeal reflux in benign vocal mucosal lesions. Otolaryngol Head Neck Surg 141(3):369–373

    Article  PubMed  Google Scholar 

  7. Sulica L, Blitzer A (2007) Vocal fold paresis: evidence and controversies. Curr Opin Otolaryngol Head Neck Surg 15:159–162

    Article  PubMed  Google Scholar 

  8. Merati AL, Shemirami N, Smith TL, Toohill RJ (2006) Changing trends in the nature of vocal fold motion impairment. Am J Otolaryngol 27:106–108

    Article  PubMed  Google Scholar 

  9. Simpson CB, May LS, Green JK, Eller RL, Jackson CE (2011) Vibratory asymmetry in mobile vocal folds: is it predictive of vocal fold paresis? Ann Otol Rhinol Laryngol 120:239–242

    Article  PubMed  Google Scholar 

  10. Dursun G, Sataloff RT, Spiegel JR, Mandel S, Heuer RJ, Rosen DC (1996) Superior laryngeal nerve paresis and paralysis. J Voice 10:206–211

    Article  CAS  PubMed  Google Scholar 

  11. Koufman JA, Postma GN, Cummins MM, Blalock PD (2000) Vocal fold paresis. Otolaryngol Head Neck Surg 122:537–541

    CAS  PubMed  Google Scholar 

  12. Heman-Ackah YD, Batory M (2003) Determining the etiology of mild vocal fold hypomobility. J Voice 17:579–588

    Article  PubMed  Google Scholar 

  13. Heman-Ackah YD, Barr A (2006) Mild vocal fold paresis: understanding clinical presentation and electromyographic findings. J Voice 20:269–281

    Article  PubMed  Google Scholar 

  14. Simpson CB, Cheung EJ, Jackson CJ (2009) Vocal fold paresis: clinical and electrophysiologic features in a tertiary laryngology practice. J Voice 23:396–398

    Article  PubMed  Google Scholar 

  15. Bach KK, Belafsky PC, Wasylik K, Postma GN, Koufman JA (2005) Validity and reliability of the Glottal Function Index. Arch Otolaryngol Head Neck Surg 131(11):961–964

    Article  PubMed  Google Scholar 

  16. Belafsky PC, Postma GN, Koufman JA (2001) Validity and reliability of the Reflux Symptom Index (RSI). Laryngoscope 111:1313–1317

    Article  CAS  PubMed  Google Scholar 

  17. Rubin AD, Praneetvatakul V, Heman-Ackah Y, Moyer CA, Mandel S, Sataloff RT (2005) Repetitive phonatory tasks for identifying vocal fold paresis. J Voice 19:679–686

    Article  PubMed  Google Scholar 

  18. Hirano M, Bless DM (1993) Videostroboscopic examination of the larynx. Singular Publishing, San Diego

    Google Scholar 

  19. Koufman JA, Walker FO (1998) Laryngeal electromyography in clinical practice: indications, techniques, and interpretation. Phonoscope 1:57–70

    Google Scholar 

  20. Sataloff RT, Mandel S, Manon-Espaillat R, Heman-Ackah YD, Abaza M (2003) Basic aspects of the electrodiagnostic evaluation. In: Sataloff RT, Korovin GS (eds) Laryngeal electromyography. Delmar Learning, Clifton Park, pp 8–58

    Google Scholar 

  21. Sataloff RT, Mandel S, Manon-Espaillat R, Heman-Ackah YD, Abaza M (2003) Laryngeal electromyography. In: Sataloff RT, Korovin GS (eds) Laryngeal electromyography. Delmar Learning, Clifton Park, pp 59–85

    Google Scholar 

  22. Yin SS, Qiu WW, Stucker FJ (1997) Major patterns of laryngeal electromyography and their clinical application. Laryngoscope 107:126–136

    Article  CAS  PubMed  Google Scholar 

  23. Koufman JA, Postma GN, Whang CS, Rees CJ, Amin MR, Belafsky PC, Johnson PE, Connolly KM, Walker FO (2001) Diagnostic laryngeal electromyography: the Wake Forest experience 1995–1999. Otolaryngol Head Neck Surg 124(6):603–606

    Article  CAS  PubMed  Google Scholar 

  24. Koufman JA, Belafsky PC (2001) Unilateral or localized Reinke’s edema (pseudocyst) as a manifestation of vocal cord paresis: the paresis podule. Laryngoscope 111:576–580

    Article  CAS  PubMed  Google Scholar 

  25. Altman KW (2005) Laryngeal asymmetry on indirect laryngoscopy in a asymptomatic patient should be evaluated with electromyography. Arch Otolaryngol Head Neck Surg 131(4):356–359

    Article  PubMed  Google Scholar 

  26. Belafsky PC, Postma GN, Reulbach TR, Holland BW, Koufman JA (2002) Muscle tension dysphonia as a sign of underlying glottal insufficiency. Otolaryngol Head Neck Surg 127(5):448–451

    Article  PubMed  Google Scholar 

  27. Altman KW, Atkinson C, Lazarus C (2005) Current and emerging concepts in muscle tension dysphonia: a 30-month review. J Voice 19(2):261–267

    Article  PubMed  Google Scholar 

  28. Colton RH, Woo P, Brewer DW, Griffin B, Casper J (1995) Stroboscopic signs associated with benign lesions of the vocal folds. J Voice 9(3):312–325

    Article  CAS  PubMed  Google Scholar 

  29. Statham MM, Rosen CA, Nandedkar SD, Munin MC (2010) Quantitative laryngeal electromyography: turns and amplitude analysis. Laryngoscope 120(10):2036–2041

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Daniel B. Magraw from Johns Hopkins University for editorial assistance in the preparation of this manuscript.

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None.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Semsi Denizer Cad. E-5 Cevizli Mevkii, Kartal, 34890, Istanbul, Turkey

    Sevtap Akbulut, Derya Berk & Mustafa Paksoy

  2. Department of Neurology, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey

    Rahsan Adviye Inan

  3. Department of Otolaryngology Head and Neck Surgery, Acibadem Hospital, Istanbul, Turkey

    Hande Altintas

  4. Department of Otolaryngology Head and Neck Surgery, Silopi State Hospital, Sirnak, Turkey

    Ibrahim Gul

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  1. Sevtap Akbulut
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  2. Rahsan Adviye Inan
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  3. Hande Altintas
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  4. Ibrahim Gul
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  5. Derya Berk
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  6. Mustafa Paksoy
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Correspondence to Sevtap Akbulut.

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Akbulut, S., Inan, R.A., Altintas, H. et al. Vocal fold paresis accompanying vocal fold polyps. Eur Arch Otorhinolaryngol 272, 149–157 (2015). https://doi.org/10.1007/s00405-014-3227-8

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  • DOI: https://doi.org/10.1007/s00405-014-3227-8

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