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VOCALIST Does Laryngeal Reinnervation or Type I Thyroplasty give better voice results for patients with Unilateral Vocal Fold Paralysis?

VOCALIST Inclusion Criteria

VOCALIST Exclusion Criteria

  • UVFP due to unilateral recurrent laryngeal nerve paralysis of traumatic, iatrogenic or idiopathic origin of between 6 and 60 months duration, or symptoms that have not sufficiently improved with speech therapy alone, as determined by the patient and agreed by a multidisciplinary clinical team after 6 months and pending a surgical decision.
  • Age from 18 to 70 years old
  • Able to provide informed consent
  • A significant voice disorder as measured by perceptual rating (Grade ≥2 GRBAS Scale) and VHI-10 score (score >16)
  • Common EMG (neurophysiological) criteria (Koufman Grades 2-5)
  • Impaired vocal fold mobility but a normal EMG (Koufman Grade I)
  • Severe lung disorders
  • Structural vocal fold lesions such as polyp
  • Previous laryngeal framework surgery
  • Cricoarytenoid joint fixation (CAJF)
  • Significant non-laryngeal speech abnormality (severe dysarthria determined by a panel of trained speech therapists)
  • Previous Level 2, 3 or 4 thyroid neck dissection
  • Previous ipsilateral surgical neck dissection
  • Previous radiotherapy to the head and neck
  • Laryngeal injection of a rapidly absorbable material in the last 6 months
  • Previous laryngeal injection of a non-rapidly absorbable material (e.g. bioplastics, VOX)
  • Neuromuscular disease affecting the larynx or multiple cranial nerve palsies