Behavioral Readjustment Therapy versus Vocal Fold Injection in the Management of Swallowing Disorders in Cases of Unilateral Vocal Fold Paralysis | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 104, Volume 94, Issue 1, January 2024, Page 710-718 PDF (391.84 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2024.342168 | ||||
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| Abstract | ||||
| Background: Unilateral vocal fold immobility (UVFI) is the most prevalent neurological disease affecting the larynx. Objective: This work aimed to evaluate management of oropharyngeal dysphagia in cases of unilateral vocal fold paralysis (UVFP) by either behavioral readjustment therapy (BRAT) or vocal fold injection (VFI) to provide the best management technique regarding safety and effectiveness in these patients. Methods: This study was carried out on 20 consecutive candidates of both sexes with vocal fold immobility and dysphagia for BRAT or VFI. They were aged from 20 to 60 years old, both sexes. Patients were divided randomly into two equal groups: Group I included odd numbers received BRAT with mean age of 42.3 ± 15.21 years and group II that included even numbers received VFI with mean age of 45.1 ± 12.56. Results: The glottic gap was significantly better in one week and three months follow-up for injection group than behavioral group. The presence of the residue one week post intervention showed non-significant difference between both groups.Penetration aspiration scale (PAS) after one week and 3 months of intervention for fluids showed a significant difference between both groupsbut PAS for semisolids and solids showed no significant difference between them.Food consistency was affected and choking of fluid showed a significant difference in both groups. Conclusions: Injection laryngoplasty (IL) and BRAT could improve oropharyngeal dysphagia in patients with unilateral VFP. IL improved the glottal closure, therefore it improved airway protection and increased cough power, so it helps to prevent aspiration. BRAT improved motor power and motor control of swallowing in oropharyngeal phase, improved impaired sensation, improved bolus flow, and decreased the patient’s symptoms. | ||||
| Keywords | ||||
| Behavioral readjustment therapy; Vocal fold injection; Swallowing; Unilateral vocal fold paralysis | ||||
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