ALA040 - Demographic Differences in the Treatment of Unilateral Vocal Fold Paralysis
Friday, April 29, 2022
10:56 AM – 11:02 AM CT
Location: Landmark D
Mit A. Patel, MD; Jonathan M. Bock, MD; Joel H. Blumin, MD; David R. Friedland, MD, PhD; Jazzmyne Adams, MPH; Ling Tong, MA; Kristen Osinski, MS; Jake Luo, PhD
Background/Objectives: Unilateral vocal fold paralysis (UVFP) is the most common neurological laryngeal disorder resulting in dysphonia and dysphagia. UVFP can cause functional communication and quality of life changes, and thus requires effective patient-specific treatment. The purpose of this study was to determine the impact of patient demographics and insurance status on treatment pathways for UVFP to potentially improve care delivery for this disorder.
Methods: Electronic medical records of patients with UVFP at the Froedtert & the Medical College of Wisconsin between 2009-2019 were reviewed. Patient demographics (age, sex, race, ethnicity, insurance type) were compared with different treatments options for UVFP.
Results: Of 1578 patients, 538 (34%) chose observation, 512 (32%) injection laryngoplasty, 366 (23%) speech therapy, 136 (9%) type I thyroplasty, and 26 (2%) reinnervation surgery. Median age was 50.8 and most patients were White (85%) and female (58%). Younger patients (median, 39.13 years) were more likely to undergo reinnervation surgery. Males had higher odds (OR 1.32; CI 1.08, 1.61) of undergoing injection laryngoplasty whereas females had higher odds (OR 1.39; CI 1.09, 1.76) of undergoing speech therapy. Black patients were most likely to have speech therapy and least likely to undergo injection laryngoplasty. Patients with public insurance were more likely to have thyroplasty than those with private insurance (OR 1.48; CI 1.03, 2.14).
Conclusions: Treatment selection of UVFP was influenced by patient demographics. Future studies will explore the influence of underlying etiology and medical comorbidities on treatment selection.