Author(s)
Solomon Husain, BS
Babak Sadoughi, MD
Niv Mor, MD
Lucian Sulica, MD
Affiliation(s)
Weill Cornell Medical College; Maimonides Medical College
Abstract:
Objective: This study aims to determine the rate and natural time course of iatrogenic vocal fold paralysis (IaVFP) recovery. Methods: Records of 294 patients with IaVFP treated between 2006 and 2017 were reviewed. Patients seen >1 year after onset (27), lost to follow up (70) or with framework surgery <1 year from onset (76) were excluded. Patient demographics, disease onset, recovery and treatment details, including timing and type of injection augmentation and surgery were recorded. Recovery was defined as return of normal vocal quality. Results: 121 patients (76F:45M, age 58±13.9, 82 L:32 R:7 Bilateral) were included in the study. 55 patients did not undergo injection augmentation; time course could be assessed in 42 patients who recovered (31F:11M, age 55±14.4). Overall, they recovered in a mean of 175±109 days. Mean time to recovery of R-sided paralysis was 222±115.6 days; L-sided paralysis was 166±104.8 days (p-value=0.091). Patients were stratified by anatomic site of surgery. Mean time to recovery was 180±124 days after neck (20F:4M, age 53±13.8), 144±80 days after thoracic (2F:3M, age 46±15.0), 171±116 days after skull-base (3F:1M, age 56±9.0), 135±40 days after intubation (4F:1M, age 61±10.7), and 239±100 days after carotid (2F:2M, age 75±8.2). ANOVA testing demonstrated a p-value of 0.67. The overall probability of recovery was 71% at 3 months, 59% at 6 months, 40% at 9 months, and 20% at 12 months. Conclusion: Recovery time of IaVFP is not defined by injury site or laterality. Recovery rates at time from injury may be better guides for determining intervention.