Overview
Acquired vocal cord palsy involves the loss of function in one or both vocal cords, often leading to dysphonia and potential respiratory issues. This condition can result from various etiologies including surgical complications, as seen in cases following thyroplasty 1.Diagnosis
Clinical Presentation: Dysphonia, potential respiratory distress, and subjective voice quality changes.
Objective Assessment: Tussometry can objectively assess vocal cord function by evaluating peak value time of airflow during coughing, independent of lung function 2.
Imaging: Laryngoscopy may be necessary to visualize vocal cord position and identify structural abnormalities.
Grading: Often assessed based on the degree of vocal cord immobility and impact on voice quality, though specific grading scales are not detailed in the provided abstracts.Management
First-Line Treatments:
- Speech Therapy: Initial management often includes voice therapy to optimize remaining vocal function 1.
- Surgical Interventions: Thyroplasty or vocal cord augmentation with implants (e.g., Silastic) for medialization to improve voice quality 1.
Adjunctive Treatments:
- Reinnervation Procedures: Considered for cases where nerve regeneration might restore function, though not detailed in the abstracts.
- Pharmacologic Interventions: Not specifically mentioned in the provided abstracts.Special Populations
Surgical Complications: Higher risk in patients undergoing laryngeal surgeries, as evidenced by post-thyroplasty implant extrusion cases 1.
No Specific Guidance: Limited data on pregnancy, pediatrics, or elderly populations from the provided abstracts.Key Recommendations
Utilize tussometry for objective assessment of vocal cord function post-intervention, providing a reproducible measure of outcomes (Evidence: Moderate 2).
Consider surgical augmentation (e.g., thyroplasty with implants) for persistent dysphonia despite conservative management, noting potential for fibrous tissue stabilization even post-extrusion 1.
Initiate speech therapy early in management to optimize voice quality and function (Evidence: Expert opinion 1).References
1 Al-Yousuf A, Jain A, Parker AJ. Postthyroplasty implant extrusion. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP) 2006. link
2 Murty GE, Kelly PJ, Bradley PJ. Tussometry: an objective assessment of vocal cord function. The Annals of otology, rhinology, and laryngology 1993. link