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Voice and unilateral vocal fold paralysis

Voice outcomes are the main comparators when managing unilateral vocal fold paralysis (UVP). In a review of the literature, 11 voice indicators are included in 80% of all articles. However, when surgeons were surveyed on their clinical preferences and their...

Surgical management of permanent facial paralysis

This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...

Surgically improving pharyngeal paralysis and associated dysphagia

This was an interesting article explaining the current methods used to try and improve dysphagia and in some cases associated problematic aspiration following vagal injury. These patients are often those with other associated cranial neuropathies, with skull base lesions, brain...

Iatrogenic vocal fold paralysis – the time to recovery

Iatrogenic vocal fold paralysis can result from stretching, compression or complete transection of recurrent laryngeal or vagus nerves. These injuries are a significant source of concern for patients and clinicians alike. The question is how long should we wait for...

Facial paralysis risk factors in benign parotid surgery

The literature shows that the risk of facial paralysis following benign parotid surgery can be as high as 57% for temporary weakness and 7% for permanent facial nerve damage. It is generally thought that the factors involved may be related...

The use of botulinum toxin A to reverse paralysis of the lower lip

The aim of this retrospective case series was to examine the role of botulinum toxin A in paediatric patients with paralysis of the lower lip. Depressor or elevator muscles of the lip (unaffected side) were injected with varying doses of...

Endoscopic findings and prediction of outcome in unilateral vocal cord paralysis

Unilateral vocal cord paralysis which is not due to irreversible causes such as malignancy, systemic disease or trauma varies considerably in terms of full recovery and restoration of voice. Usually electromyography is used to make possible predictions, but this facility...

Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

The benefits of early voice therapy for unilateral vocal cord paralysis

This retrospective review of voice outcomes following a diagnosis of unilateral vocal fold paralysis divided patients into three groups according to the time of initiation of voice therapy following the onset of paralysis. The ‘early’ group started voice therapy within...

What blood tests should be requested to investigate vocal cord paralysis?

Patients who are discovered to have a vocal cord palsy with no obvious cause on history or examination routinely undergo investigations to exclude an underlying pathology. Cross-sectional imaging of the relevant recurrent laryngeal nerve is required, but considerable variability has...

Transmastoid facial nerve decompression for persistent traumatic facial nerve paralysis

Facial nerve paralysis (FNP) can occur following trauma, with a small number of these patients requiring facial nerve decompression (FND) to aid recovery. The authors shared their experience in decompressing the facial nerve for persistent severe FNP via a transmastoid...