Evidence-based practice: evaluation and management of unilateral vocal fold paralysis

Otolaryngol Clin North Am. 2012 Oct;45(5):1083-108. doi: 10.1016/j.otc.2012.06.011. Epub 2012 Jul 31.


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.

Publication types

  • Review

MeSH terms

  • Electromyography / methods*
  • Evidence-Based Practice*
  • Humans
  • Laryngoplasty* / adverse effects
  • Laryngoplasty* / methods
  • Polymers / therapeutic use
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Recurrent Laryngeal Nerve / physiopathology
  • Risk Factors
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Vocal Cord Paralysis* / complications
  • Vocal Cord Paralysis* / diagnosis
  • Vocal Cord Paralysis* / physiopathology
  • Vocal Cord Paralysis* / surgery
  • Vocal Cords* / diagnostic imaging
  • Vocal Cords* / innervation
  • Vocal Cords* / physiopathology
  • Voice Disorders* / etiology
  • Voice Disorders* / therapy
  • Voice Quality
  • Voice Training*


  • Polymers