Unilateral vocal fold paralysis and paresis

Patients with unilateral vocal fold paralysis and paresis represent a heterogeneous group with wide variation in symptom severity, ranging from mild limitations such as vocal fatigue or difficulty with singing voice, to near aphonia, dysphagia, aspiration and dyspnea. Appropriate evaluation, counseling and treatment require an in-depth understanding of the pathophysiology of laryngeal neuropathy because each patient is different, and a "one-size-fits-all" approach is not likely to succeed. Because of the heterogeneity of this population, the breadth of treatment options, and patient and physician preferences, standardizing treatment approaches and obtaining high-level evidence has been a challenge. Nevertheless, physicians can help guide patients to treatment options that have the highest likelihood for success by familiarizing themselves with the available literature.