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competence influence the increased prevalence of aspira-
tion observed in patients with UVFI.
The results of the present study confirm the quali-
tative findings of Jang et al. with objective data. In that
study, individuals with UVFI of peripheral origin (i.e.,
recurrent laryngeal nerve injury, vagus nerve injury, or
idiopathic etiologies) presented with subjective sugges-
tion of abnormal laryngeal elevation and epiglottic inver-
sion, residue in the valleculae, residue in the pyriform
sinuses, and aspiration.
4
The percentage of aspiration in this study was also
comparable to previous studies, which identified aspira-
tion in approximately 33% to 42% of individuals with
UVFI.
2–5
It is important to note that the present study
was performed in an outpatient tertiary care center and
most of the previous work evaluating aspiration in
patients with UVFI was performed in acute care set-
tings. Although information about the length of time
from the onset of vocal fold immobility was not available
in these studies, we suspect that the individuals
included in the present investigation may have had a
more prolonged duration of UVFI in comparison to pre-
vious work. Nonetheless, the percentage of aspiration in
the current investigation was similar to previous
findings.
When evaluating UVFI between groups, the only
significant finding was total pharyngeal transit time.
This may be the result of a higher vagal injury in the
idiopathic group, compared to the iatrogenic group. How-
ever, this confirmed that, although the iatrogenic group
was more likely isolated to recurrent laryngeal nerve
and/or superior laryngeal nerve injury than the idio-
pathic group, the finding of increased PCR did not vary
significantly between groups. Additionally, the iatrogenic
group was approaching significance compared to the con-
trol group, and significance may be achieved with a
larger sample size. Therefore, pharyngeal weakness may
exist in individuals with UVFI of both idiopathic and
iatrogenic etiologies.
This study was not without limitations. Electromy-
ography was not utilized to determine the site of lesion
causing UVFI. Also, in an effort to keep the groups as
homogenous as possible, the sample size was small.
However, the groups that were chosen were intended to
represent individuals with UVFI limited to vagus nerve
injury. None of the individuals underwent a vocal fold
medialization procedure prior to study, and all individu-
als presented with a dysphagia complaint. In addition,
this study was retrospective, so a future prospective
investigation with a larger sample size is required to
confirm these results.
CONCLUSION
Individuals with UVFI of iatrogenic and idiopathic
etiologies with subjective dysphagia demonstrate objec-
tive evidence of pharyngeal weakness. The increased
prevalence of aspiration in this population may not be
solely the result of impaired airway protection.
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