When a patient comes in with vocal fold paralysis, physicians should immediately start thinking about the long-term approach. “We should be thinking about how we’re going to work up these patients and how to manage and measure outcomes systematically,” Dr. Francis said.
The question of whether imaging is needed is a matter of some controversy, he added, although there’s been a “long history” of obtaining a computerized tomography (CT) scan to assess the recurrent laryngeal nerve. “A consensus still exists that some imaging should be done to rule out mass lesions along the recurrent laryngeal nerve in most cases,” he said.
Timing from symptom onset to presentation is a key consideration when determining management. Dr. Francis said that it can take six to 12 months for the nerve to regenerate back to the laryngeal muscles it innervates after denervation injury. Determining whether and when recovery will occur is complicated; often, it is not known where the nerve is injured, how severely it is injured, and what the odds of recovery are.| ← Previous | | | Next → | Single Page