Response to McFarlane I appreciate the opportunity to respond again to McFarlane. It was not the intention of my letter to contest the concept of conservative therapy for unilateral vocal fold paralysis patients during the first 9-12 months. Certainly, most otolaryngologists would agree the conservative therapy, frequently including voice therapy, is usual and ... Letter to the Editor
Letter to the Editor  |   May 01, 1992
Response to McFarlane
 
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Speech, Voice & Prosodic Disorders / Voice Disorders / Swallowing, Dysphagia & Feeding Disorders / Professional Issues & Training / Speech, Voice & Prosody / Letters to the Editor
Letter to the Editor   |   May 01, 1992
Response to McFarlane
American Journal of Speech-Language Pathology, May 1992, Vol. 1, 67. doi:10.1044/1058-0360.0103.67
 
American Journal of Speech-Language Pathology, May 1992, Vol. 1, 67. doi:10.1044/1058-0360.0103.67
I appreciate the opportunity to respond again to McFarlane. It was not the intention of my letter to contest the concept of conservative therapy for unilateral vocal fold paralysis patients during the first 9-12 months. Certainly, most otolaryngologists would agree the conservative therapy, frequently including voice therapy, is usual and customary for the first 9-12 months following onset. However, a procedure (Teflon injection, thyroplasty, or nerve transfer) is generally performed after this waiting period. (Some patients require earlier surgical treatment if aspiration is present.)
Our results with ansa cervicalis-recurrent laryngeal nerve anastomosis have been uniformly excellent when both nerves are present and viable. All patients are studied postopera-tively with such objective studies as jitter, shimmer, vowel airflow, speech airflow, video strobe analysis, and fundamental frequency. Currently we are involved in an NIH-funded study comparing this form of treatment with thyroplasty and Teflon injection. Several otolaryngologists, most of them at such academic institutions as UCLA, Washington University (St. Louis), and University of Washington (Seattle), have performed the ansa-RLN anastomosis procedure.
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