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Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing

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Vocal fold immobility and aspiration status: a direct replication study.

Steven B Leder¹, Debra M Suiter, Dianne Duffey

¹Department of Surgery, Section of Otolaryngology, Yale University School of Medicine, New Haven, CT 06520-8041, USA. steven.leder@yale.edu

|August 23, 2011

Summary

Vocal fold immobility (VFI) affects 4.3% of patients undergoing swallowing evaluations and significantly increases aspiration risk. This study confirms VFI is common and linked to higher odds of aspirating liquids or purees.

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Area of Science:

Otolaryngology
Speech-Language Pathology
Gastroenterology

Background:

Vocal fold immobility (VFI) is a potential cause of dysphagia and aspiration.
Previous studies suggest a link between VFI and aspiration, but direct replication is needed.

Purpose of the Study:

To replicate and confirm the incidence of VFI.
To investigate the relationship between VFI and pharyngeal dysphagia and aspiration.
To analyze factors influencing VFI and aspiration, including side, etiology, and bolus type.

Main Methods:

A direct replication study using a single-group, consecutively referred case series.
2,650 participants underwent fiberoptic endoscopic evaluation of swallowing (FEES).
Data were combined with a previous study (n=1,452) for a total of 4,102 participants.

Main Results:

The incidence of VFI was 4.3% (112/2,650), with left VFI being most common (58%).
Aspiration occurred in 22% of participants; 40% of those with VFI aspirated.
Individuals with VFI had 2.50 times the odds of aspirating (OR=2.50, 95% CI=1.86-3.37).
Liquid aspiration was more frequent than puree aspiration.
Males had a higher incidence of VFI than females.

Conclusions:

VFI is a significant and not uncommon finding in patients evaluated for dysphagia.
VFI substantially increases the odds of aspiration, regardless of bolus type.
Left VFI is frequently associated with surgical trauma, and males are more affected.