Swallowing Evaluation in VF Immobility

Swallowing Disorder

Vocal fold immobility (VFI) often results in significant problems with dysphonia, dysphagia, and decreased cough strength. As one element of the dysphagia potentially associated with vocal fold immobility, aspiration may create significant morbidity for these patients. An estimated 38% to 53% of patients with untreated VFI have swallowing difficulties with aspiration. Vocal fold immobility has important implication on the laryngeal airway protection during respiration, phonation and swallowing. It is the most common neurological laryngeal disorder. The immobility may be caused by neck and thoracic surgery. which can impair the innervation of the pharynx, upper esophageal sphincter (U.E.S) and proximal esophagus but may also be due to malignancy,trauma, Intracranial causes,or may be idiopathic

Besides the voice alteration, the lesion that causes of vocal fold immobility should also affect the pharyngeal phase of swallowing. It was suggested that dysphagia in patient with vocal fold immobility has multifactor causes ; including limited airway protection and decrease laryngopharyngeal sensation based on the finding of the flexible endoscopy. Another study revealed that pharyngeal phase abnormalities such as delayed initiation of swallowing, reduced laryngeal elevation, and reduced upper esophageal sphincter (UES) opening were found in video fluoroscopic swallowing studies (VFSS). Several studies on the swallowing difficulties of patient with vocal fold immobility has been performed and reported that nearly 56% of these patients immobility have swallowing dysfunction.

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