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<p>Unilateral vocal cord palsy (UVCP), commonly caused by iatrogenic injury, malignancy, or idiopathic factors, results in voice impairment. To our knowledge, this is the first study to demonstrate a significant interaction between the timing of injection laryngoplasty (IL) and underlying aetiology in UVCP management. We hypothesize that early IL improves vocal function in UVCP, with iatrogenic cases demonstrating more pronounced response. This retrospective cohort study included adult patients with UVCP who underwent hyaluronic acid injection laryngoplasty between January 2021 and December 2025. Patients were categorized into early (&lt; 3 months) and late (≥ 3 months) injection groups. Voice outcomes were assessed using maximum phonation time (MPT) and the overall grade of dysphonia, roughness, breathiness, asthenia, and strain (GRBAS) rating scale at baseline and 3 months post-injection. Statistical comparisons between groups and aetiologies were performed using Mann–Whitney U and Kruskal–Wallis tests, with significance set at <i>p</i> &lt; 0.05. Among 37 patients (51% male, mean age 59.9 ± 14.5 years), UVCP was more common on the left side (68%). Seventeen patients received early IL. Early intervention led to significantly greater improvements in MPT (<i>p</i> = 0.04) and overall GRBAS grade (<i>p</i> = 0.02). Within the early injection group, iatrogenic cases demonstrated the greatest voice improvements, with significant differences in MPT (<i>p</i> = 0.01) and breathiness (<i>p</i> = 0.04). Early IL is associated with better voice outcomes across all UVCP aetiologies, with particularly favourable results in iatrogenic cases. Tailoring intervention timing to the underlying aetiology may shape evidence-based clinical guidelines, improving patient outcomes and satisfaction.</p>

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The Dual Impact of Aetiology and Intervention Timing in Unilateral Vocal Cord Palsy

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Sien Hui Tan,
  • Sakina Ghauth

摘要

Unilateral vocal cord palsy (UVCP), commonly caused by iatrogenic injury, malignancy, or idiopathic factors, results in voice impairment. To our knowledge, this is the first study to demonstrate a significant interaction between the timing of injection laryngoplasty (IL) and underlying aetiology in UVCP management. We hypothesize that early IL improves vocal function in UVCP, with iatrogenic cases demonstrating more pronounced response. This retrospective cohort study included adult patients with UVCP who underwent hyaluronic acid injection laryngoplasty between January 2021 and December 2025. Patients were categorized into early (< 3 months) and late (≥ 3 months) injection groups. Voice outcomes were assessed using maximum phonation time (MPT) and the overall grade of dysphonia, roughness, breathiness, asthenia, and strain (GRBAS) rating scale at baseline and 3 months post-injection. Statistical comparisons between groups and aetiologies were performed using Mann–Whitney U and Kruskal–Wallis tests, with significance set at p < 0.05. Among 37 patients (51% male, mean age 59.9 ± 14.5 years), UVCP was more common on the left side (68%). Seventeen patients received early IL. Early intervention led to significantly greater improvements in MPT (p = 0.04) and overall GRBAS grade (p = 0.02). Within the early injection group, iatrogenic cases demonstrated the greatest voice improvements, with significant differences in MPT (p = 0.01) and breathiness (p = 0.04). Early IL is associated with better voice outcomes across all UVCP aetiologies, with particularly favourable results in iatrogenic cases. Tailoring intervention timing to the underlying aetiology may shape evidence-based clinical guidelines, improving patient outcomes and satisfaction.