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Rehabilitation Practice and Science

Translated Title

手術相關與腫瘤相關單側聲帶麻痺之臨床與肌電圖差異

Abstract

Background: The etiologies of unilateral vocal fold paralysis (UVFP) could be highly varied. It could be idiopathic or related to surgery, infection, radiation, and tumor. Among these causes of UVFP, surgery-related and idiopathic UVFP were the most well studied. However, the clinical characteristics of tumor-related UVFP have been discussed in only a few studies. Therefore, we evaluated the clinical and electromyographic characteristics of tumor-related UVFP and compared them with those of surgery-related UVFP. Methods: Laryngeal electromyography (LEMG) was performed in the thyroarytenoid-lateral cricoarytenoid muscle complexes and the cricothyroid muscles. The Short Form-36 quality-of-life questionnaire (SF-36) was applied to evaluate the patient’s quality of life. The LEMG and SF-36 findings were compared between the surgery-related and tumor-related groups. Results: Among the 138 patients recruited, five were excluded because of incomplete data collection. The remaining 133 patients were divided into the surgery-related (n=119) and tumor-related (n=14) groups. Patients in the tumor-related group (right/left=1/13) had a significantly higher proportion of left vocal fold involvement than did the patients in the surgery-related group (right/left=45/74). Subgroup analysis revealed that thyroid surgery (56%) and thyroid tumor (36%) were the leading causes of UVFP in the surgery-related and tumor-related groups, respectively. LEMG showed no significant differences in the proportion of spontaneous activity (p=0.54), polyphasia (p=0.52), and recruitment (p=0.6) between the two groups. SF-36 findings showed that the tumor-related group had significantly higher scores than the surgery-related group in general health perceptions (60.7±18.8 vs 48.022.9; p=0.049), role limitations due to physical health (60.7±47.7 vs 32.9±43.6;p=0.028), and bodily pain (89.1±19.0 vs 76.1±23.2;p=0.032). Conclusion: Compared to patients with surgery-related UVFP, patients with tumor-related UVFP have a distinct clinical presentation with a higher percentage of left-sided vocal fold involvement and a less negative impact on quality of life. Patients in the tumor-related group also had better life quality indices such as general health perceptions, role limitations due to physical health, and bodily pain score. LEMG characteristics might not be useful in differentiating tumor-related and surgery-related UVFP.

Language

Traditional Chinese

First Page

11

Last Page

18

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