You have accessSIG 3 Voice and Upper Airway DisordersCE Questions31 Oct 2019

Updates on Vocal Fold Paralysis

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      ARTICLE 1

      Update: Behavioral Management of Unilateral Vocal Fold Paralysis and Paresis, by Schneider

      https://doi.org/10.1044/2019_PERS-SIG3-2018-0018

      1. Patient reported outcome measures are useful to:

      1. identify a laryngeal diagnosis

      2. obtain standardized patient self-assessment

      3. guide voice therapy

      4. make referrals to other professionals

      2. When a patient is stimulable for vocal change this indicates:

      1. voice therapy will be helpful

      2. they can achieve a “better” voice

      3. they are motivated for voice therapy

      4. they are a good therapeutic candidate

      3. Identify a vibratory parameter that can only be assessed using videostroboscopy:

      1. vocal fold abduction and adduction

      2. supraglottic hyperfunction

      3. patterns of secretion pooling

      4. vocal fold closure and duration

      4. In the case of a vocal fold motion impairment, what vocal fold position is desired and may help improve efficacy of voice therapy?

      1. lateral

      2. median

      3. paramedian

      4. any

      5. If a patient's immobile vocal fold is in the midline position however vocal fold closure cannot be assessed due to aperiodic vibration, voice therapy may be most effective if the patient is:

      1. stimulable for vocal change, self-aware and motivated

      2. not stimulable for change, self-aware and motivated

      3. stimulable for change, self-aware, and unmotivated

      4. stimulable for change, not self-aware and motivated

      ARTICLE 2

      Medical and Surgical Advances in the Treatment of Unilateral Vocal Fold Paralysis, by Nelson, Bryson, Reghunathan, and Benninger

      https://doi.org/10.1044/2019_PERS-SIG3-2018-0017

      6. A patient presents with new dysphonia for about 1 month and is diagnosed with a new unilateral vocal fold paralysis. Her exam is otherwise normal, and she has had no recent neck or chest surgery. Immediately before the onset of her dysphonia she had a mild upper respiratory infection. Which of these treatments should be reserved until the patient is 6–12 months out from the initial onset of symptoms?

      1. computed tomography of the neck with IV contrast

      2. medialization laryngoplasty

      3. voice therapy

      4. injection laryngoplasty with hyaluronic acid

      7. Injection laryngoplasty with hyaluronic acid typically provides an expected duration of benefit for how long?

      1. less than 1 week

      2. approximately 3–4 weeks

      3. approximately 3–4 months

      4. approximately 1 year or longer

      8. What is currently the most common cause of unilateral vocal fold paralysis?

      1. idiopathic

      2. extralaryngeal malignancy

      3. traumatically induced

      4. surgically induced

      9. What is the best therapeutic recommendation for a relatively healthy 65-year-old with a known history of vocal fold paralysis following thyroidectomy 5 years ago who has previously benefited from injection laryngoplasty with hyaluronic acid and would like a more permanent treatment?

      1. calcium hydroxylapatite injection laryngoplasty

      2. recurrent laryngeal nerve re-innervation

      3. medialization laryngoplasty

      4. voice therapy

      10. What are the chances of spontaneous recovery of vocal fold motion in a patient who has a newly diagnosed idiopathic vocal fold paralysis?

      1. < 15%

      2. 20–60%

      3. 70–90%

      4. recovery is certain

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