High‐resolution manometry and swallow outcomes after vocal fold injection medialization for unilateral vocal fold paralysis/paresis

Background Injection medialization is performed to improve glottic closure, thereby airway protection. Overall objective to determine if unilateral injection medialization changes glottal area with concomitant adjustments in penetration/aspiration scale (PAS) scores and pharyngeal high‐resolution ma...

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Bibliographic Details
Published in:Head & neck 2019-07, Vol.41 (7), p.2389-2397
Main Authors: Kammer, Rachael E., Jones, Corinne A., Johnson, Aaron M., Dailey, Seth H., McCulloch, Timothy M., Thibeault, Susan L.
Format: Article
Language:English
Subjects:
dysphagia
Head and neck
Injection
medialization
Paralysis
Paresis
pharyngeal high‐resolution manometry
Pharynx
Pressure
Respiratory tract
Swallowing
vocal fold paralysis
Vocal organs
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Summary:Background Injection medialization is performed to improve glottic closure, thereby airway protection. Overall objective to determine if unilateral injection medialization changes glottal area with concomitant adjustments in penetration/aspiration scale (PAS) scores and pharyngeal high‐resolution manometry (HRM) parameters. Methods Enrolled 17 adults with unilateral vocal fold paralysis/paresis and aspiration/penetration. Fiberoptic endoscopic evaluation of swallowing and pharyngeal HRM completed at (1) baseline (within 1 week before injection), (2) postinjection (within 1 week post injection), and (3) 1‐month postinjection. Comparisons between time points for PAS scores, glottal area, pharyngeal pressure, and timing. Results No significant differences in normalized glottal area. No significant differences in PAS scores, for any consistency. Significantly increased rate of mesopharynx pressure rise and maximum pressure at 1 month postinjection (P = .01 and .02, respectively) compared to baseline. Significant decrease in mesopharynx integral from baseline to 1 week postoperative (P = .03). Conclusion Findings suggest unilateral vocal fold injection medialization had limited effect on swallow function.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.25715