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European Archives of Oto-Rhino-Laryngology

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01-10-2018 | Laryngology

Vocal fold paresis: Medical specialists’ opinions on standard diagnostics and laryngeal findings

Authors: Gerd Fabian Volk, Sebastian Themel, Markus Gugatschka, Claus Pototschnig, Christian Sittel, Andreas H. Müller, Orlando Guntinas-Lichius, For the Working Group on Laryngology and Tracheal Diseases of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the Working Group on Neurolaryngology of the European Laryngological Society (ELS)

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2018

Abstract

Purpose

There is still no clear consensus on the diagnostic value of specific laryngeal findings in patients with suspected vocal fold paresis (VFP). The aim of the study was to establish expert opinion on criteria for the diagnosis of VFP in Europe.

Methods

A cross-sectional survey using the questionnaire introduced by Wu and Sulica for US American experts was addressed to laryngeal experts in Germany, Austria, and Switzerland and in a second survey wave to members of the European Laryngological Society.

Results

100 respondents returned survey 1 (response rate 47.2%). 26% worked at a university department. 28% regularly used laryngeal electromyography (LEMG). A pathologic test results in LEMG was considered to have the strongest positive predictive value for VFP (79 ± 23%), followed by a decreased vocal fold abduction (70 ± 29%), decreased vocal fold adduction (61 ± 34%), and atrophy of the hemilarynx (61 ± 31%). The multivariate analysis showed the predictive value of LEMG was estimated lower by respondents from non-university hospital (β = − 16.33; confidence interval (CI) = − 25.63 to − 7.02; p = 0.001) and higher in hospitals with higher frequency of VFP patients per months (β = 1.57; CI = − 0.98 to 2.16; p < 0.0001). 30 ELS members returned survey 2 (response rate, 8.4%). Their answers were not significantly different to survey 1.

Conclusions

The laryngology experts in Europe rely on LEMG for diagnosis of VFP like the US American experts, but paradoxically only a minority uses LEMG frequently. Next to LEMG, motion abnormities were considered to have the best predictive value for the diagnosis of VFP.

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Title: Vocal fold paresis: Medical specialists’ opinions on standard diagnostics and laryngeal findings
Authors: Gerd Fabian Volk
Sebastian Themel
Markus Gugatschka
Claus Pototschnig
Christian Sittel
Andreas H. Müller
Orlando Guntinas-Lichius
For the Working Group on Laryngology and Tracheal Diseases of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the Working Group on Neurolaryngology of the European Laryngological Society (ELS)
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 10/2018
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-018-5102-5

At a glance: The STEP trials

Springer Medicine

Vocal fold paresis: Medical specialists’ opinions on standard diagnostics and laryngeal findings

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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