Journal article
Effect of Medialization on Dyspnea Index in Unilateral Vocal Fold Paralysis
Otolaryngology-head and neck surgery, Vol.167(2), pp.327-333
08/01/2022
DOI: 10.1177/01945998211056515
PMID: 34752158
Abstract
Objective Patients with unilateral vocal fold paralysis commonly report dysphonia and dysphagia. Dyspnea also occurs, with studies on treatment-related change producing mixed results. Studies including patient-reported outcomes have focused on single-question global scales. The Dyspnea Index (DI) includes 10 questions, is specific to upper airway-related dyspnea, and may better capture these patients' symptoms. We evaluated change in DI after treatment. Study Design Retrospective review. Setting Academic medical center. Methods Forty-three patients with unilateral vocal fold paralysis underwent injection augmentation (n = 25) or framework surgery (n = 18). DI was recorded preprocedure, 2 to 4 weeks afterward, and at approximately 3 months afterward in 19 patients. Voice Handicap Index-10, Glottal Function Index, Cough Severity Index, and Eating Assessment Tool-10 were also recorded. Change in parameters and correlations were assessed. Obesity, cardiac disease, pulmonary disease, and procedure (injection vs framework surgery) were evaluated for effect on DI. Results Twenty-four patients had an abnormal baseline DI (>10). DI decreased from 14.9 +/- 13.8 to 6.5 +/- 9.3 after treatment (P < .001; 95% CI, 4.7-12.1). Twenty-eight scores decreased, 9 remained unchanged, and 6 increased. Change in DI was influenced by the presence of cardiac disease. Decreased DI persisted at 3-month follow-up. Voice Handicap Index-10, Glottal Function Index, Cough Severity Index, and Eating Assessment Tool-10 scores decreased and were correlated with change in DI. Conclusion Upper airway-related dyspnea is common in unilateral vocal fold paralysis, occurring in half of this cohort. Correcting glottic insufficiency may alleviate symptoms. Treatment decision making should consider postprocedural change in dyspnea, especially in patients for whom dyspnea is a motivating factor for seeking treatment.
Details
- Title: Subtitle
- Effect of Medialization on Dyspnea Index in Unilateral Vocal Fold Paralysis
- Creators
- Matthew R. Hoffman - University of AlabamaBeau Vandiver - University of Alabama at BirminghamNatalie Derise - University of Alabama at BirminghamEdie R. Hapner - University of Alabama at BirminghamGlen Leverson - University of Wisconsin–MadisonC. Blake Simpson - University of Alabama
- Resource Type
- Journal article
- Publication Details
- Otolaryngology-head and neck surgery, Vol.167(2), pp.327-333
- Publisher
- Sage
- DOI
- 10.1177/01945998211056515
- PMID
- 34752158
- ISSN
- 0194-5998
- eISSN
- 1097-6817
- Number of pages
- 7
- Language
- English
- Date published
- 08/01/2022
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984366362602771
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