Clin Exp Otorhinolaryngol.  2017 Sep;10(3):203-212. 10.21053/ceo.2017.00199.

Current Treatment Options for Bilateral Vocal Fold Paralysis: A State-of-the-Art Review

• Li Y
• Garrett G
• Zealear D

• KMID: 2395733
• DOI: http://doi.org/10.21053/ceo.2017.00199

Abstract

Vocal fold paralysis (VFP) refers to neurological causes of reduced or absent movement of one or both vocal folds. Bilateral VFP (BVFP) is characterized by inspiratory dyspnea due to narrowing of the airway at the glottic level with both vocal folds assuming a paramedian position. The primary objective of intervention for BVFP is to relieve patients' dyspnea. Common clinical options for management include tracheostomy, arytenoidectomy and cordotomy. Other options that have been used with varying success include reinnervation techniques and botulinum toxin (Botox) injections into the vocal fold adductors. More recently, research has focused on neuromodulation, laryngeal pacing, gene therapy, and stem cell therapy. These newer approaches have the potential advantage of avoiding damage to the voicing mechanism of the larynx with an added goal of restoring some physiologic movement of the affected vocal folds. However, clinical data are scarce for these new treatment options (i.e., reinnervation and pacing), so more investigative work is needed. These areas of research are expected to provide dramatic improvements in the treatment of BVFP.

Keyword

Vocal Cord Paralysis; Synkinesis; Recurrent Laryngeal Nerve Injuries; Electric Stimulation Therapy; Botulinum Toxins

MeSH Terms

Botulinum Toxins
Cordotomy
Dyspnea
Electric Stimulation Therapy
Genetic Therapy
Larynx
Paralysis*
Recurrent Laryngeal Nerve Injuries
Review Literature as Topic*
Stem Cells
Synkinesis
Tracheostomy
Vocal Cord Paralysis
Vocal Cords*
Botulinum Toxins