Evidence-Based Practice. Evaluation and Management of Unilateral Vocal Fold Paralysis

Stephanie N Misono, Albert L. Merati

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations


This article discusses the causes and symptoms, evaluation, and management of unilateral vocal fold paralysis (UVFP). Cross-sectional imaging is appropriate in the work-up of idiopathic UVFP, but the routine use of serology is not well supported. The usefulness of laryngeal electromyography has remained controversial. Predictors of poor prognosis for functionally meaningful recovery include fibrillation potentials, positive sharp waves, and absent/reduced voluntary motor unit potentials. Voice therapy may be helpful. Injection and laryngeal framework surgery (medialization thyroplasty) improve vocal quality. The vocal impact of laryngeal reinnervation is comparable with that of medialization. Some patients may benefit from multiple procedures.

Original languageEnglish (US)
Pages (from-to)1083-1108
Number of pages26
JournalOtolaryngologic Clinics of North America
Issue number5
StatePublished - Oct 1 2012


  • Evidence-based otolaryngology
  • Larynx
  • Unilateral vocal fold paralysis
  • Vocal cord paralysis
  • Voice therapy

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