- 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
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