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Updated: May 18, 2026

Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Evidence-based practice: evaluation and management of unilateral vocal fold paralysis
Stephanie Misono1, Albert L Merati
1Department of Otolaryngology/Head and Neck Surgery, University of Minnesota, 420 Delaware Street Southeast, MMC 396, Minneapolis, MN 55455, USA. smisono@umn.edu
Abstract:
This article discusses the causes and symptoms, evaluation, and management of unilateral vocal fold paralysis (UVFP). Cross-sectional imaging is appropriate in the work-up of idiopathic UVFP, but the routine use of serology is not well supported. The usefulness of laryngeal electromyography has remained controversial. Predictors of poor prognosis for functionally meaningful recovery include fibrillation potentials, positive sharp waves, and absent/reduced voluntary motor unit potentials. Voice therapy may be helpful. Injection and laryngeal framework surgery (medialization thyroplasty) improve vocal quality. The vocal impact of laryngeal reinnervation is comparable with that of medialization. Some patients may benefit from multiple procedures.
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