Epidemiology and available treatments for bilateral vocal fold paralysis: an international clinical registry

Introduction:

The international BVFP registry started in 2015 is collecting data on the characteristics of BVFP population as well as standard diagnostic, treatment and follow-up methods.

Methods:

Retro-and prospective data collection in an international, observatory, systematic registry with adaptive design. The core team includes 7 clinics in Germany, 3 in Austria, and 1 in Ukraine. Data collection per patient covered 2 years after treatment.

Results:

291 retrospective data-sets have been included, 209 (71% female) have been analysed. The most usual cause for BVFP is iatrogenic (79%). Average age of the patients was 56 years. The most commonly used diagnostic tool was videolaryngoscopy (85%). The golden standard therapy was glottal enlargement (49%), followed by tracheostomy (24%), mostly limited to emergency cases. 12% of the patients received no treatment. The most common glottal enlargement methods are posterior cordotomy (pCh; 27%), the combination of pCh + partial arytenoidectomy (26%) and pCh + laterofixation + partial arytenoidectomy (23%).

Post-treatment follow-up was performed in less than 50% of the cases and mostly limited to VHI administration (20%). Post-treatment follow-up was performed in less than 50% of the cases and mostly limited to VHI administration (20%). At least 1 revision surgery was required within 2 years in 24% of the patients who had a glottal enlargement, while it reached 51% for patients who received a tracheostomy.

Conclusions:

Revision surgery is frequent. Follow-up is highly variable. A clinical guideline would be helpful to improve quality of care for BVFP.

Publication History

Publication Date:
18 April 2018 (online)