Treating Vocal Fold Paralysis with Medialization

Larynx.
© Bartleby.com: Gray’s Anatomy, Plate 1204

Treating vocal fold paralysis with medialization involves a series of decisions that can sometimes be difficult to make. A panel of experts assembled at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting to give tips to session attendees on the best approaches to surgical timing and technique, and to explain how to determine whether medialization is needed at all.

Pre-Procedure Decisions

David Francis, MD, MS, assistant professor of otolaryngology at the Vanderbilt Voice Center in Nashville, said there is often a several-month delay before someone with unilateral vocal fold paralysis actually sees a voice specialist. If a patient sees a general otolaryngologist before seeing the voice physician, it takes a median of nine months to be seen by the voice specialist. “This has significant implications for treatment planning,” he said.

The decision of whether and when to perform an injection augmentation or type I laryngoplasty requires an understanding of the physiology, along with audio-perceptual, visual-perceptual and, importantly, patient-reported factors.