Unilateral vocal cord mobility impairment and laryngopulmonary physiology
Reviewed by Andy Hall

The concept of iatrogenic recurrent laryngeal nerve injury following thyroid surgery is often considered with respect to voice change but its potential impact on airway physiology has thus far not been evaluated. A cross-sectional observational study reviewed 21 patients with unilateral vocal fold mobility impairment (UVFMI) against 53 control patients with no history of lung disease or laryngeal pathology. The authors identified a reproducible flow-volume loop pattern suggestive of selective inspiratory airway obstruction in UVFMI patients. The findings allow flow-volume loops to act as an objective measure of laryngeal abductor function. The authors recognise the potential value in confirming a diagnosis of recurrent laryngeal palsy or indeed measuring a change in airway physiology as an arbiter of success in vocal cord medialisation procedures. The hidden prevalence of UVFMI (and indeed better understanding of surgical complications) may perhaps be better understood through incorporation of this easily accessible physiological test, particularly where other surgical disciplines may not have access to post-operative laryngoscopy.

Impact of unilateral vocal fold mobility impairment on laryngopulmonary physiology.
Nouraei SA, Whitcroft K, Patel A, et al.
CLINICAL OTOLARYNGOLOGY
2014;39:209-15.