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Τρίτη 28 Σεπτεμβρίου 2021

Cord Medialization in Unilateral Vocal fold paralysis improves forced vital capacity

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Abstract

Objective

The lateralized vocal fold of unilateral vocal fold paralysis (ULVFP) is unphysiological for expiration wherein vocal folds normally adduct to increase expiratory resistance and prevent small airway collapse. ULVFP may therefore impair ventilatory function and ventilatory volume. This study seeks to test if vocal fold medialization improves forced vital capacity (FVC).

Design

Prospective inception cohort intervention study.

Setting

Academic Tertiary Care Institution.

Participants

Twenty-five patients of ULVFP with a phonatory gap ranging from 2-6 mm.

Main outcome measures

Vocal fold medialization undertaken with autologous fat injection. Forced Vital Capacity (FVC) assessments by spirometry undertaken pre-treatment and 1month post-treatment.

Results

Improvement in FVC noted in all patients with the quantum of improvement ranging from 0.1 to 0.6 liters. Mean FVC improved from 3.10 liters pre-injection to 3.45 liters post-injection. (p<0.001). A moderate correlation was noted between the degree of medialization and improvement in FVC (r=0.33, Pearson's Correlation Coefficient)

Conclusion

Objective improvement in FVC is consistently noted post vocal fold medialization for ULVFP, and is probably mediated by increased glottic expiratory resistance and consequent improvement in intrinsic PEEP.

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