What findings do laryngologists consider significant in the diagnosis of vocal fold (VF) paresis using strobolaryngoscopy, and which clinical signs are considered most compelling?
Most laryngologists use strobolaryngoscopy for paresis diagnosis. Although certain clinical findings were found to be associated with diagnosis, these varied among raters, especially when determining sidedness and nerve involvement.
Explore this issue:September 2017
Background: A 2015 survey of 58 fellowship-trained laryngologists found that 89% of respondents diagnosed paresis predominantly on laryngoscopic examination, with 81% of this subset relying on stroboscopic light. Laryngoscopic and stroboscopic findings believed to have the strongest positive predictive value for paresis were VF motion anomalies (slow/sluggish VF motion: 75%; decreased adduction: 67%; and decreased abduction: 65%), and signs of VF degeneration (decreased VF tone: 61%). Determining which of these clinical signs is most compelling may help further clarify diagnosis.
Study design: Retrospective cohort study of 34 videostroboscopic examinations (24 with paresis, eight without paresis, two repeats).