The voice box is involved in breathing, voice and airway protection. Vocal fold palsy occurs when some of the voice box muscles are paralysed after thyroid or heart surgery, due to cancer, or with stroke or Parkinson’s disease. Patients experience hoarseness, with many also having swallowing problems. This can cause serious complications when liquid or saliva spills into the airway (aspiration) leading to pneumonia. Historically, management includes supportive care whilst waiting for the nerve to recover (up to 12 months), but this places some people at high risk for pneumonia. There is a simple surgical procedure (injection laryngoplasty) that helps the voice and reduces risk of aspiration. This can now be done in the clinic, in the awake patient.
We will use new technology (high resolution pharyngeal manometry) with clinical assessments to characterise the swallow pattern in patients from diagnosis, following treatment, and longterm follow-up. This study will determine how effective the surgery is with improving swallowing and develop a 'clinical screen' to predict those at greatest risk of aspiration and would benefit from early surgical treatment.