Inpatient injection laryngoplasty for vocal fold immobility: When is it really necessary?

Am J Otolaryngol. 2017 Mar-Apr;38(2):222-225. doi: 10.1016/j.amjoto.2017.01.016. Epub 2017 Jan 18.

Abstract

Purpose: To compare pulmonary and swallow outcomes of injection laryngoplasty when performed in the acute versus subacute setting in head & neck and thoracic cancer patients presenting with new onset unilateral vocal fold immobility.

Materials and methods: Case series with chart review at an academic cancer center over a 2year period. Based on swallow evaluation, patients diagnosed with vocal fold immobility were grouped into an unsafe swallow group, injected as inpatients, and a safe swallow group, for whom injection laryngoplasty was delayed to the outpatient setting or not performed. Rates of pneumonia, diet recommendations, and swallow outcomes were compared between groups.

Results: 24 patients with new-onset vocal fold immobility were evaluated. 7 underwent injection in the inpatient setting, 12 in the outpatient setting, and 5 did not undergo injection. There was no perceived difference in speech and swallow outcomes between the inpatient and outpatient injection groups.

Conclusions: Injection laryngoplasty shows promise as an effective intervention for reducing aspiration risk and improving diet normalcy in patients with dysphagia as a result of unilateral vocal fold immobility. In patients determined to have a safe swallow, delay of injection laryngoplasty is not detrimental to swallow outcomes.

Keywords: Dysphagia; Injection laryngoplasty; Swallow outcomes; Vocal fold immobility.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Head and Neck Neoplasms / complications
  • Humans
  • Injections
  • Laryngoplasty / methods*
  • Laryngoscopy
  • Male
  • Middle Aged
  • Retrospective Studies
  • Severity of Illness Index
  • Thoracic Neoplasms / complications
  • Treatment Outcome
  • Vocal Cord Paralysis / etiology*
  • Vocal Cord Paralysis / therapy*