Document Detail


Diagnosis of vocal fold paresis: Current opinion and practice.
MedLine Citation:
PMID:  25394306     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
LEVEL OF EVIDENCE: 5 Laryngoscope, 2014.
Authors:
Amy P Wu; Lucian Sulica
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-13
Journal Detail:
Title:  The Laryngoscope     Volume:  -     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-13     Completed Date:  -     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 The American Laryngological, Rhinological and Otological Society, Inc.
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