Swallowing Evaluation in VF Immobility

Study Overview
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Brief Summary
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Vocal fold immobility (VFI) often results in significant problems with dysphonia, dysphagia, and decreased cough strength. As one element of the dysphagia potentially associated with vocal fold immobility, aspiration may create significant morbidity for these patients. An estimated 38% to 53% of patients with untreated VFI have swallowing difficulties with aspiration. Vocal fold immobility has important implication on the laryngeal airway protection during respiration, phonation and swallowing. It is the most common neurological laryngeal disorder. The immobility may be caused by neck and thoracic surgery. which can impair the innervation of the pharynx, upper esophageal sphincter (U.E.S) and proximal esophagus but may also be due to malignancy,trauma, Intracranial causes,or may be idiopathic

Detailed Description
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Besides the voice alteration, the lesion that causes of vocal fold immobility should also affect the pharyngeal phase of swallowing. It was suggested that dysphagia in patient with vocal fold immobility has multifactor causes ; including limited airway protection and decrease laryngopharyngeal sensation based on the finding of the flexible endoscopy. Another study revealed that pharyngeal phase abnormalities such as delayed initiation of swallowing, reduced laryngeal elevation, and reduced upper esophageal sphincter (UES) opening were found in video fluoroscopic swallowing studies (VFSS). Several studies on the swallowing difficulties of patient with vocal fold immobility has been performed and reported that nearly 56% of these patients immobility have swallowing dysfunction.

Official Title
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Evaluation of Swallowing in Patients With Vocal Folds Immobility

Conditions
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Swallowing Disorder

Intervention / Treatment
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* Device: Videofluoroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age:above 18. Gender:both sexes will be included in the study. Exclusion Criteria: patients with structural abnormalities of oral cavity, pharynx or larynx. previous vocal fold injection or voice therapy. other causes of dysphagia: esophageal cancer or spasm , gastric cancer, cancer larynx,or radio therapy . . Patients with history of heart burn , acid regurgitation , other neurological disease ,stroke, hypothyroidism or dyspnea.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>Patients with Vocal fold immobility | Device: Videofluoroscopy<br>* Swallowing assessment<br>* Other names: Nasofibroscopy;|
| Control<br>Normal volunteer don't have dysphagia , neurological diseases , heart burn and acid regurgitation | Device: Videofluoroscopy<br>* Swallowing assessment<br>* Other names: Nasofibroscopy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To calculate the incidence of swallowing dysfunction in people with vocal fold immobility | Incidence of swallowing dysfunction in patients with vocal fold immobility will be determined by the Statistical Package for the Social Sciences (SPPS) after the diagnosis of swallowing dysfunction by fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallow study (VFSS) | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure the frequency of each swallowing phase which will be affected in vocal fold immobility patients | To detect which swallowing phase is causing the dysfunction by using Statistical Package for the Social Sciences (SPSS) program | Baseline |