Cough in Reduced True Vocal Fold Mobility
Condition: Unilateral Vocal Cord Paresis; Unilateral Vocal Cord Paralysis
MeSH terms: Vocal Cord Paralysis; Paralysis; Paresis
Study type: Observational

Summary: 
      This project is a first attempt to assess cough airflow dynamics and true vocal fold (TVF)
      adduction and abduction angles during voluntary cough to examine the effects of changes in
      glottal closure due to reduced mobility of one true vocal fold. The hypothesis of this study
      is that the incomplete glottal closure due to reduced vocal fold mobility will result in
      changes in true vocal fold adductory and abductory angles during cough and will result in
      changes to voluntary cough airflow parameters. This study results will contribute to the
      existing knowledge of the laryngeal contribution to cough airflow dynamics.
    

Detailed description: 
      The study investigators will consecutively recruit 30 adults diagnosed with vocal fold
      insufficiency due to reduced mobility of one true vocal fold.

      A questionnaire will be used to collect participants' information. Demographic information
      such as age, gender, race/ethnicity, height, weight, and a major complaint (dysphonia and/or
      dysphagia) and medical history information determining the eligibility for participation will
      be collected from the participant. Participant's medical and surgical history specifically
      related to the diagnosis and the etiology of reduced vocal fold mobility will be obtained
      from the participant's medical record.

      Videolaryngoscopy will be performed as part of standard clinical care. Vocal fold image and
      cough airflow will be recorded simultaneously during voluntary cough production with the
      flexible endoscope in nasopharynx. A second part of the study will include spirometry and
      expiratory muscle strength assessments. Video images of the vocal fold movement during vowel
      phonation and cough production will be recorded and stored on a CD for later analysis. The
      cough airflow recordings will be displayed, stored, and analyzed using LabChart software for
      Windows.
    

Intervention name(s): cough airflow measure; vocal tasks; true vocal fold movement; spirometry test; maximum expiratory pressure (MEP)
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): Participants will produce multiple voluntary coughs for cough airflow assessment.; The assessment of glottal closure will be performed during phonation tasks.; The true vocal fold (TVF) movement in cough will be observed and recorded during cough production.; The lung function test will require the participant to perform deep inhalations and forceful exhalations into the flow head of the spirometer during spirometry test.; The assessment of maximum expiratory pressure will require forceful exhalations into a mouthpiece of a manometer during maximum expiratory pressure (MEP) assessment.
Other intervention name(s): cough airflow assessment; phonation tasks; TVF movement; spirometry; MEP
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The participants will represent a population of patients with glottal insufficiency due to
        unilateral true vocal fold immobility.