J Korean Dysphagia Soc.  2019 Jan;9(1):40-45. 10.0000/jkdps.2019.9.1.40.

Effect of Hyaluronic Acid Injection for a Dysphagia Patient Who Has Unilateral Vocal Fold Paralysis due to a Lateral Medullary Infarction: A Case Report

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Myongji Hospital, Goyang, Korea. 1989cha@hanmail.net
  • 2Department of Physical Medicine and Rehabilitation, Masan Woori Hospital, Changwon, Korea.

Abstract

This paper reports a case of a female patient aged 48 years diagnosed with a right lateral medullary infarction and dysphagia after the onset period. In a video fluoroscopic swallowing study (VFSS), significant manifestations were not observed in the oral phase, but during swallowing aspiration, a larger amount of post-swallowing residue were observed on the test of swallowing of semisolid and liquid. After the VFSS, a laryngoscopy was performed, which indicated paralysis and para-median fixation in the right vocal fold. In this case, swallowing with rightward head rotation was adopted as a compensation technique to reduce the aspiration caused by the para-median fixation of the right vocal fold, but it was not enough to improve the dysphagia in this case. To medialize the right vocal fold, hyaluronic acid was injected with laryngoscopic guidance. In a VFSS conducted after the injection, aspiration was not observed on the test of swallowing a semisolid and liquid. The injection of hyaluronic acid is less invasive than surgical operations, does not require general anesthesia, and makes the recovery time shorter. Therefore, it is expected to be an alternative to the treatment of unilateral vocal fold paralysis (UVFP) accompanied with dysphagia.

Keyword

Dysphagia; Fluoroscopy; Vocal fold Paralysis; Hyaluronic Acid
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