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Review
. 2017 Sep;10(3):203-212.
doi: 10.21053/ceo.2017.00199. Epub 2017 Jul 4.

Current Treatment Options for Bilateral Vocal Fold Paralysis: A State-of-the-Art Review

Yike Li  1 , Gaelyn Garrett  1 , David Zealear  1
Affiliations
Review

Current Treatment Options for Bilateral Vocal Fold Paralysis: A State-of-the-Art Review

Yike Li et al. Clin Exp Otorhinolaryngol. 2017 Sep.

Abstract

Vocal fold paralysis (VFP) refers to neurological causes of reduced or absent movement of one or both vocal folds. Bilateral VFP (BVFP) is characterized by inspiratory dyspnea due to narrowing of the airway at the glottic level with both vocal folds assuming a paramedian position. The primary objective of intervention for BVFP is to relieve patients' dyspnea. Common clinical options for management include tracheostomy, arytenoidectomy and cordotomy. Other options that have been used with varying success include reinnervation techniques and botulinum toxin (Botox) injections into the vocal fold adductors. More recently, research has focused on neuromodulation, laryngeal pacing, gene therapy, and stem cell therapy. These newer approaches have the potential advantage of avoiding damage to the voicing mechanism of the larynx with an added goal of restoring some physiologic movement of the affected vocal folds. However, clinical data are scarce for these new treatment options (i.e., reinnervation and pacing), so more investigative work is needed. These areas of research are expected to provide dramatic improvements in the treatment of BVFP.

Keywords: Botulinum Toxins; Electric Stimulation Therapy; Recurrent Laryngeal Nerve Injuries; Synkinesis; Vocal Cord Paralysis.

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Conflict of interest statement

Dr. Zealear has a conflict to disclose. An Food and Drug Adminstration (FDA) approved clinical trial of laryngeal pacing is in progress through a contract with St. Jude Medical Inc. As patent inventor and principal investigator on the project, Dr. Zealear will receive royalties on sales if the commercial phase is reached with this technology. Neither of the other authors have a conflict of interest.

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