Physiology of Dysphagia in Those with Unilateral Vocal Fold Immobility.

Only patients referred for modified barium swallow were studied, so people with unilateral vocal fold immobility who had mild symptoms or no instrumental assessment were not represented. The sample was small, with only 14 aspirators, which prevented multivariable analysis and meaningful statistical comparison across etiology groups. Etiology groups were uneven and some were very small, including only 2 patients with peripheral tumor. The study was retrospective and used historical normal controls to define abnormal measures, not concurrent controls. Participants came from one outpatient voice center in the western United States, and acute care or inpatient cases were not studied. Disease duration was not controlled, so chronic compensatory changes may differ from new-onset immobility.

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Do not conclude that unilateral vocal fold immobility causes aspiration by impairing airway closure. In this small referred sample, delayed airway closure was common but did not separate aspirators from non-aspirators, and most aspirators aspirated after laryngeal closure while reduced pharyngeal constriction was more common in aspirators.