gms | German Medical Science

Background/Methods: The frequency of global respiratory impairment with unilateral vocal fold paralysis (ULP) is increasing. We examined 39 patients with ULP (mean age 54±16 years, 22 female) and 40 controls (mean age 49.7±17.2 years, 21 female). In addition to speech and voice assessment we focused on phonatory respiration [breathiness, respiration type, phonation time (PT), appropriate utterance length, phonation quotient (PQ), respiration rate] and pulmonary function as measured by flow-volume loop spirometry. Dynamic pulmo-nary volumes, flow velocities on inspiration and forced expiration, and vital capacity (VC) were registered and evaluated with reference to normal values. The most frequent cause of ULP was strumectomy. Neither patients nor controls were affected by lower airway disease.

Results: On the basis of their considerably decreased PT the patients' PQ (VC/PT) increased significantly. Spirometry showed that the patients' inspiratory flow and volume (PIF, FIV1) were reduced, but not significantly lower than those of controls. In addition, there was no significant restriction of VC and expiratory volume (FEV1) in comparison to controls. In con-trast, the expiratory flows (PEF, MEF75/50) were significantly below both control values and normal values. The MEF25 values, although still in the lower range of normal, were signifi-cantly decreased relative to control values. None of the patients showed global respiratory impairment as assessed by the relative one-second capacity.

Conclusion: The combination of somewhat low FIV1/PIF values and clearly reduced PEF/MEF values points to a constriction of the upper airway that can be quantified by means of spirometry. Therefore, spirometry ap-pears suitable for functional evaluation of upper airway obstruction. A global respiratory im-pairment could not be verified. However, in the case of additional restriction of the relative one-second capacity pulmological assessment is still recommended.