Evidence-Based Practice

Unilateral vocal fold paralysis (uvfp) has a variety of etiologies. Postsurgical, neoplasm-related, and idiopathic uvfp remain common. Cross-sectional imaging is appropriate in the workup of idiopathic uvfp, but routine use of serology is not well supported. Laryngeal electromyography may help determine prognosis. Voice therapy may be helpful. Injection and medialization thyroplasty improve vocal quality. Laryngeal reinnervation has comparable vocal impact to medialization; surgical decision making should take patient age into account. Some patients may benefit from multiple procedures. The current literature on uvfp is Oxford Evidence Grade B–C. Ongoing systematic reviews of the literature and more randomized controlled trials are needed.