2016 Volume 67 Issue 4 Pages 249-255
In our hospital, we have been treating insufficient glottic closure due to ipsilateral vocal cord paralysis or vocal cord atrophy by injecting BIOPEX-R calcium phosphate paste into the vocal cords to achieve a medial shift. We investigated the occurrence of aspiration before and after this procedure in terms of both subjective symptoms and a variety of objective findings. We used vocal cord BIOPEX injection to treat 112 cases of ipsilateral vocal cord paralysis or vocal cord atrophy in 97 patients during the 11-year 3-month period from May 2004 to July 2015. After the exclusion of 22 cases in which a condition other than insufficient glottic closure that could clearly cause aspiration was also present, the study sample comprised 90 cases in 79 patients. Subjective symptoms of aspiration were assessed on “a five-point choking frequency scale” that we devised to rate the frequency of choking when drinking water. Objective findings were assessed by rating video recordings from videofluoroscopy (VF) on an eight-point scale. Preoperatively, 57 of 90 subjects reported subjective symptoms of choking when drinking water. Postoperatively, 49 of these 57 (86%) reported that the frequency of choking had improved on the choking frequency scale. Of 12 patients who underwent preoperative and postoperative VF, aspiration was evident on preoperative VF in 10, but postoperatively no aspiration was evident in any patient. Medial shift of the vocal cords is thus an effective surgical treatment for insufficient glottic closure due to recurrent nerve paralysis.
