Unilateral Vocal Cord Paralysis
Conditions
Keywords
laryngeal electromyography, intrinsic laryngeal muscles, recurrent laryngeal nerve, superior laryngeal nerve, laryngeal sensation, tone language
Brief summary
Laryngeal motor and sensory nerve dysfunction may cause phonation and swallowing disturbance, which often happens after the treatment for laryngopharyngeal and esophageal cancer and may induce fatal complications such as aspiration pneumonia. By the conventional examinations, the tiny sensory or motor changes are hard to be detected before complete vocal paralysis. It is utmost important to establish a comprehensive quantitative method which is sensitive enough to evaluate the neuromuscular functions. The present project will evaluate the laryngeal nerve function by quantitative laryngeal electromyography, which was developed by the research team, and another novel examination technique, mucosal membrane sensation test. The comprehensive method is expected to grade the laryngeal nerve injuries quantitatively before the significant symptoms or complications and can also help to evaluate the treatment effect from medicine, rehabilitation or surgery.
Interventions
None listed
Sponsors
Chang Gung Memorial Hospital
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
20 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Patients with laryngopharyngeal or esophageal cancer who have taken active therapy and are not neck tissue damage. * Patients with clear conscious and stable mental status
Exclusion criteria
* Patients who cannot sit for longer than 30 minutes or received other vocal cord treatments before the selection * Pregnant and breastfeeding women * Patients with communication disorder
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fiberoptic endoscopic evaluation of swallowing (FEES) | Baseline:Within 3-6 months after synptom occurs | Swallowing evaluation |
| Laryngo-pharyngeal mucosa sensation test | Baseline:Within 3-6 months after synptom occurs | There were four probes of different diameters that similar to the Von Frey filament were prepared for the examination. The diameters were 0.07mm, 0.15mm.0.2 mm and 0.3 mm. The mono-filament nylon probe was placed and contact with the tip and arytenoid mucosa. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| voice range profile | Baseline:Within 3-6 months after synptom occurs | The voice will be analyzed by computerized software. The extreme lowest and highest notes of frequencies production and the amplitude will be recorded and a voice map will be made as a plot of sound pressure level versus F0. |
| laryngeal electromyography | Baseline:Within 3-6 months after synptom occurs | — |
| Disease related life quality assessment: FACT-H&N, FACT-E | Baseline:Within 3-6 months after synptom occurs | Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) and FACT-E (esophagus) are self -report questionnaires with a Likert-type response set, ranging from not at all to very much. FACT-G (general) is a 27-items scale measures four QOL (quality of life) domains including Physical Well-Being, Social/Family Well-Being, Emotional Well-Being and Functional Well-Being. In FACT-H&N, there are 11 additional specific questions for head and neck cancers while 17 additional items for esophageal cancers in FACT-E. The specific questionnaires will be provided to patients according to individual diseases. The traditional Chinese (Mandarin) version has been validated and proved to be useful in previous report. We have received the licensing agreement from the institute (FACIT) for using the questionnaires on the project. |
| Voice Handicap Index (VHI) | Baseline:Within 3-6 months after synptom occurs | Voice-related questionnaire The Voice Handicap Index (VHI) is a 30-item instrument developed by Jacobson et al. as a self-measure the psychosocial handicapping effects of voice disorders. The questionnaire consists of three sub scales: emotional, physical and functional with 10 items from each scale. It has been translated into traditional Chinese and validated. All individuals will be asked to response for the questionnaire. |
| laboratory voice analysis | Baseline:Within 3-6 months after synptom occurs | fundamental frequency, Jitter (perturbation of frequency), Shimmer (perturbation of amplitude), harmonic-to-noise ratio (HN), and s/z ratio (SZ) . |
Countries
Taiwan
Contacts
Primary ContactTuan-Jen Fang, MD
Outcome results
None listed