Injection versus medialization laryngoplasty for the treatment of unilateral vocal fold paralysis

Objective/Hypothesis: To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the treatment of unilateral vocal fold paralysis. Study Design: A retrospective study of patients with unilateral vocal fold paralysis who underwent either injection or medialization laryngoplasty at the University of Arkansas for Medical Sciences between July 29, 2003 and March 8, 2005. Methods: The data analyzed included patient characteristics and type of intervention, along with the pretreatment and posttreatment voice parameters of video-strobolaryngoscopy, perceptual analysis, and patients' subjective voice assessment. Results: Nineteen patients were evaluated. The average time from intervention to posttreatment evaluation was 3 (range, 1-9) months. Improvements were demonstrated in all three voice parameters in both the injection and the medialization groups. No significant differences were found in the degree of improvement between the two groups. Videostrobolaryngoscopy and the perceptual analysis, both rated by the authors, correlated well with each other, but they both correlated poorly with the patients' subjective voice analysis. Conclusions: Injection and medialization laryngoplasty were comparable is their improvement of subjective and objective voice outcomes. Both treatment modalities should be included in the otolaryngologist's armamentarium for managing unilateral vocal fold paralysis.