Cover HSC Section6_Nov2016-Book.pdf

ABLE OF

ONTENTS

Selected Recent Materials - Reproduced in this Study Guide

NOVEMBER 2016 SECTION 6:

LARYNGOLOGY, VOICE DISORDERS, AND

BRONCHOESOPHAGOLOGY

ADDITIONAL REFERENCE MATERIAL…………………………………………................

i-ii

LARYNGOLOGY

A. Neurolaryngology: Injection and Diagnostics

Domer AS, Leonard R, Belafsky PC. Pharyngeal weakness and upper esophageal

sphincter opening in patients with unilateral vocal fold immobility.

Laryngoscope

. 2014;

124(10):2371-2374. EBM level 4....................................................................................1-4

Summary:

Individuals with unilateral vocal fold immobility of iatrogenic and idiopathic etiologies

with subjective dysphagia demonstrate objective evidence of pharyngeal weakness. The increased

prevalence of aspiration in this population may not solely be the result of impaired airway

protection.

Li M, Chen S, Wang W, et al. Effect of duration of denervation on outcomes of ansa-

recurrent laryngeal nerve reinnervation.

Laryngoscope

. 2014; 124(8):1900-1905. EBM

level 4.............................................................................................................................5-10

Summary:

Although delayed laryngeal reinnervation is proved valid for unilateral vocal fold

paralysis, surgical outcome is better if the procedure is performed within 2 years after nerve injury

than after 2 years.

Paddle PM, Mansor MB, Song PC, Franco RA Jr. Diagnostic yield of computed

tomography in the evaluation of idiopathic vocal fold paresis.

Otolaryngol Head Neck

Surg

. 2015; 153(3):414-419. EBM level 4.................................................................11-16

Summary:

This study reviewed charts of 174 patients with a diagnosis of idiopathic unilateral

vocal fold paresis (IUVFP) who underwent CT scan from skull base to mediastinum in a tertiary

laryngology practice over a 10-year period. Of the 174 patients, 5 patients had a cause for their

paresis identified on CT. This equated to a diagnostic yield of 2.9% (95% confidence interval,

0.94% to 6.6%). In addition, 48 patients had other incidental lesions identified that required

further follow-up, investigation, or treatment. This equated to an incidental yield of 27.6% (95%

confidence interval, 21.1% to 34.9%). This review demonstrates a low diagnostic yield and a high

incidental yield. These findings suggest that the routine use of CT in the evaluation of idiopathic

vocal fold paresis should be given careful consideration and that a tailored approach to

investigation with good otolaryngologic follow-up is warranted.