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have dysphagia complaints that could be explained by
any other etiology in their medical history). The etiology
of UVFI was identified as iatrogenic in 17 individuals
and idiopathic in eight individuals. The cohort was 52%
female with a mean age of 61 (614) years.
Comparison of the Idiopathic Group, Iatrogenic
Group, and Control Group
The idiopathic group (n 5 8) was 50% female with a
mean age of 64 (614) years (Table II). The iatrogenic
group (n 5 17) was 53% female with a mean age of 60
years (614) years. There was no difference in age or
gender between groups (P > 0.05).
The mean UESmax was 0.76 (60.07) cm for the idi-
opathic group, 0.85 (60.05) cm for the iatrogenic group,
and 1.0 (60.05) cm for the control group. There were no
significant differences between any groups for UESmax
(P > 0.01).
The PCR was 0.18 (60.04) for the idiopathic group,
0.12 (60.02) for the iatrogenic group, and 0.06 ( 60.01)
for the control group. PCR was significantly greater for
the idiopathic group compared with the control group
(P < 0.01). PCR for the iatrogenic group was not signifi-
cant, but less than the control group (P > 0.01). There
was not a significant difference between the idiopathic
or iatrogenic groups (P > 0.01).
The HLx was 1.58 (60.15) cm for the idiopathic
group, 1.25 (60.14) cm for the iatrogenic group, and 1.42
(60.12) cm for the control group (P > 0.01). There were
no significant differences between any groups for HLx
(P > 0.01).
The Hmax was 1.84 (60.16) cm for the idiopathic
group, 1.91 (60.16) cm for the iatrogenic group, and 2.22
(60.18) cm for the control group (P > 0.01). There were
no significant differences between any groups for Hmax
(P > 0.01).
The mean TPT was 2.66 (60.93) seconds for the idi-
opathic group, 1.36 (60.09) seconds for the iatrogenic
group, and 1.01 (60.06) seconds for the control group
(P > 0.01). There was a significant difference between
the idiopathic UVFI and iatrogenic UVFI groups
(P < 0.01). There was a significant difference between
the idiopathic group and the control group. There was
not a significant difference between the iatrogenic and
the control group.
Thirty-eight percent of individuals with idiopathic
UVFI and 35% of individuals with iatrogenic UVFI aspi-
rated at least once during the videofluoroscopic swallow
study. There was not a significant difference between
either of the UVFI groups (P > 0.05); however, there was
a significant difference between the idiopathic group and
control group ( P < 0.05), as well as the iatrogenic group
and control group (P < 0.05).
UVFI Group Compared With the Control Group
The mean UESmax opening was 0.82 (60.04) cm for
the UVFI group compared to 1.00 (60.05) cm for controls
(P > 0.05 see Table III). The pharyngeal constriction ratio
was 0.14 ( 60.02) for the UVFI group compared to 0.06
(60.01) for controls (P < 0.05). Larynx to hyoid approxi-
mation was 1.35 (60.11) cm for the UVFI group and 1.42
(60.12) cm for the control group (P > 0.05). The mean for
hyoid displacement was 1.89 ( 60.12) cm for the UVFI
group and 2.22 (60.17) cm for the control group
(P > 0.05). The mean TPT was 1.78 (60.32) seconds for
the UVFI group and 1.01 (60.06) seconds for the control
group (P < 0.05). Thirty-six percent of individuals with
UVFI aspirated at least once during the videofluoroscopic
swallow study compared to 0% of controls ( P < 0.05).
DISCUSSION
The data in the current investigation provided evi-
dence to suggest that individuals with UVFI of iatro-
genic and idiopathic etiologies may present with
additional biomechanical findings that may increase the
prevalence of aspiration. The group of individuals with
UVFI of idiopathic and iatrogenic etiologies demon-
strated significantly prolonged TPT and elevated PCRs,
suggesting delayed bolus transit and pharyngeal weak-
ness. Additionally, individuals with UVFI of idiopathic
etiology demonstrated significantly prolonged TPT,
increased PCR (i.e., pharyngeal weakness), and
decreased UESmax compared to controls. These findings
support the notion that factors other than glottal
TABLE II.
Mean, Standard Deviation, and P Value for Iatrogenic and Idio-
pathic Groups.
Iatrogenic
UVFI vs.
Idiopathic UVFI
Iatrogenic (n5 17)
Mean (SD)
Idiopathic (n 5 8)
mean (SD) P Value
UESmax (cm) 0.85 (0.05) 0.76 (0.07) 1.00
PCR 0.12 (0.02) 0.18 (0.04) 0.34
HLx (cm) 1.25 (0.14) 1.58 (0.15) 0.55
Hmax (cm) 1.91 (0.16) 1.84 (0.16) 1.00
TPT (seconds) 1.36 (0.09) 2.66 (0.93) 0.04
a 5 0.01.
*Statistical significance.
HLx 5 hyoid to larynx approximation; Hmax 5 hyoid excursion;
PCR 5 pharyngeal constriction ratio; SD5 standard error; TPT 5 total pha-
ryngeal transit time; UESmax 5 upper esophageal sphincter opening;
UVFI5 unilateral vocal fold immobility.
TABLE III.
Mean, Standard Deviation, and P Value for UVFI Group and
Controls.
UVFI vs.
Controls
UVFI (n 5 25)
Mean (SD)
Controls (n 5 25)
Mean (SD) P Value
UESmax (cm) 0.82 (0.05) 1.00 (0.05) 0.94
PCR 0.14 (0.02) 0.06 (0.01) 0.03*
HLx (cm) 1.35 (0.11) 1.42 (0.12) 0.94
Hmax (cm) 1.89 (0.12) 2.21 (0.17) 0.16
TPT (seconds) 1.78 (0.32) 1.01 (0.06) 0.02*
a 5 0.05
*Statistical significance.
HLx 5 hyoid to larynx approximation; Hmax 5 hyoid excursion;
PCR 5 pharyngeal constriction ratio; SD 5 standard error; TPT 5 total pha-
ryngeal transit time; UESmax 5 upper esophageal sphincter opening;
UVFI 5 unilateral vocal fold immobility.
Laryngoscope 124: October 2014 Domer et al.: PCR and UES Opening in UVFI
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