Clin Exp Otorhinolaryngol.  2020 Nov;13(4):340-360. 10.21053/ceo.2020.00409.

Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics

Affiliations
  • 1Department of Otorhinolaryngology-Head Neck Surgery, National Cancer Center, Goyang, Korea
  • 2Department of Otorhinolaryngology-Head Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Otorhinolaryngology-Head Neck Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
  • 4Department of Otorhinolaryngology-Head Neck Surgery, Ewha Womans University College of Medcine, Seoul, Korea
  • 5Department of Otorhinolaryngology-Head Neck Surgery, Gachon University College of Medicine, Incheon, Korea
  • 6Department of Otorhinolaryngology-Head Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 7Department of Otorhinolaryngology-Head Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea
  • 8Department of Otorhinolaryngology-Head Neck Surgery, Yonsei University College of Medicine, Seoul, Korea
  • 9Department of Speech-Language Pathology, Dongshin University, Naju, Korea
  • 10Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

The Korean Society of Laryngology, Phoniatrics and Logopedics appointed a task force to establish clinical practice guidelines for the management of unilateral vocal fold paralysis (UVFP). These guidelines cover a comprehensive range of management-related factors, including the diagnosis and treatment of UVFP, and provide in-depth information based on current, up-to-date knowledge. Detailed evidence profiles are provided for each recommendation. The CORE databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers, using a predefined search strategy. When insufficient evidence existed, expert opinions and Delphi questionnaires were used to fill the evidence gap. The committee developed 16 evidence-based recommendations in six categories: initial evaluation (R1–4), spontaneous recovery (R5), medical treatment (R6), surgical treatment (R7–14), voice therapy (R15), and aspiration prevention (R16). The goal of these guidelines is to assist general otolaryngologists and speech-language pathologists who are primarily responsible for treating patients with UVFP. These guidelines are also intended to facilitate understanding of the condition among other health-care providers, including primary care physicians, nurses, and policy-makers.

Keyword

Functional Recovery; Guideline; Laryngeal Framework Surgery; Laryngoplasty; Voice Training; Vocal Fold Paralysis

Figure

  • Fig. 1. Flowchart for the management of unilateral vocal fold paralysis. EMG, electromyography; UVFP, unilateral vocal fold paralysis; GRBAS, grade, roughness, breathiness, asthenic, and strained; NHR, noise-to-harmonic ratio; CPP, cepstral peak prominence; UVFP, unilateral vocal fold paralysis.


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