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Diagnosis of Paralytic Dysphonia and Its Clinical Characteristics

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Pathophysiology and Surgical Treatment of Unilateral Vocal Fold Paralysis

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Abstract

Three-dimensional (3D) computed tomography is used to assess the 3D configuration of the laryngeal lumen. We propose a novel classification of 3D glottal configuration, in which the thickness of the affected vocal fold during phonation is the key determinant. In the type A configuration, the thickness is nearly equal to that of the unaffected vocal fold. In the type B situation, the affected fold is thinner than the other fold during both phonation and inhalation. In the type C condition, the affected fold is thinner than the other during phonation but, paradoxically, exhibits adduction and an increase in thickness during inhalation. Vocal function in patients with the type A configuration is significantly better than in those with type B or C configurations, whereas no significant difference in vocal function is evident between patients with configurations of types B and C. Over-adduction of the unaffected vocal fold may not compensate for vocal function. Further studies are necessary to associate glottal configuration types with reinnervation patterns evident upon electromyographic analysis and to determine why some patients with unilateral vocal fold paralysis exhibit over-adduction of the unaffected fold during phonation whereas others do not, despite the presence of a posterior glottal gap.

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Notes

  1. 1.

    Breathy dysphonia and poor swallowing in patients with unilateral VFP and inspiratory dyspnea in those with bilateral VFP

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Authors and Affiliations

  1. Department of Otlaryngology Head and Neck Surgery, Graduate School of Medical Sciences Kumamoto University, Kumamoto, Japan

    Eiji Yumoto

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  1. Eiji Yumoto
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Yumoto, E. (2015). Diagnosis of Paralytic Dysphonia and Its Clinical Characteristics. In: Pathophysiology and Surgical Treatment of Unilateral Vocal Fold Paralysis. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55354-0_4

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  • DOI: https://doi.org/10.1007/978-4-431-55354-0_4

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55353-3

  • Online ISBN: 978-4-431-55354-0

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