Otolaryngology–Head and Neck Surgery Outcomes
The Division of Laryngology at Mass Eye and Ear is one of the busiest laryngology centers in New England. Providing a wide variety of therapies from surgery to voice therapy, the division has administered care to patients with voice, swallowing and breathing difficulties since 1888. From 2020 to 2021, more than 800 patients underwent augmentation laryngoplasties for unilateral vocal fold paralysis.
Treating vocal fold paralysis
Unilateral vocal fold paralysis (UVFP) occurs from a nerve injury to one of the vocal folds. The result is a weak, breathy voice, difficulty swallowing, coughing, choking and shortness of breath. Patients with UVFP suffer from communication and swallowing difficulties and are at an increased risk for aspiration and pneumonia.
The treatment for UVFP is augmentation laryngoplasty, which involves moving the weak vocal fold to help compensate for the paralysis. Various methods are used, but the most common procedure is an injection of gel into the affected vocal fold. Augmentation laryngoplasty can be performed in the office or in the operating room. Most injections at Mass Eye and Ear are performed under local anesthesia in an office setting.
Voice Handicap Scale–10
The Voice Handicap Scale–10 (VHI-10) is a validated outcome instrument that measures the quality-of-life impact on voice and communication problems.
These questions include the emotional, physical and social consequences of voice problems. Higher numbers correlate with higher disabilities and problems. A meaningful clinical difference is considered any change in score that lowers the number by more than three.
Correcting vocal fold paralysis improves a patient’s ability to communicate, socialize and work. The results show a statistically significant change in VHI scores after augmentation laryngoplasty.
VHI-10 scores six months after treatment
Eating Assessment Tool–10
The Eating Assessment Tool–10 (EAT–10 scale) is a set of 10 questions that asks patients about swallowing problems, including physical problems, such as weight loss and aspiration, as well as psychosocial impact, such as embarrassment and depression.
Any score greater than three is abnormal and problematic. Correcting vocal fold paralysis demonstrated significant improvement in swallowing function and aspiration protection.