Cricothyroid Muscle Dysfunction Affects Aerodynamic Performance in Patients with Unilateral Vocal Fold Paralysis

Kuo Cheng Liu, Yi An Lu, Li Ang Lee, Hsueh Yu Li, Alice MK Wong, Yu Cheng Pei*, Tuan Jen Fang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations


BACKGROUND: Emerging evidence has revealed that cricothyroid (CT) muscle dysfunction in unilateral vocal fold paralysis (UVFP) further impairs patients' voices. Given that CT muscle dysfunction does not influence vocal fold position, the mechanism of voice dysfunction induced by dysfunction of CT muscle in UVFP patients remains controversial. This study compares aerodynamics between UVFP patients with and without CT muscle involvement.

METHODS: This cross-sectional study recruited patients with UVFP manifesting dysphonia, and UVFP was confirmed with videolaryngoscopy and laryngeal electromyography (LEMG). Voice analysis and aerodynamic tests were further performed. Patients with (CT+ group) and without (CT- group) CT muscle involvement were compared.

RESULT: A total of 175 patients (40 in the CT+ group and 135 in the CT- group) with UVFP were analyzed. The CT+ group showed lower maximal sound pressure level (SPL) (P=0.039), mean SPL (P=0.042), peak air pressure (P<0.001), mean peak air pressure (P<0.001) and aerodynamic power (P=0.004) than the CT- group.

CONCLUSION: The decrease in SPL, peak air pressure, and aerodynamic power in UVFP patients with CT muscle dysfunction suggests that the effect of CT muscle dysfunction is mediated by a change in aerodynamics.

Original languageEnglish
Pages (from-to)219-224
Number of pages6
JournalJournal of Voice
Issue number1
StatePublished - 01 2024
Externally publishedYes

Bibliographical note

Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.


  • Aerodynamics
  • Air pressure
  • Cricothyroid
  • Glottal gap
  • Unilateral vocal fold paralysis
  • Vocal Cord Paralysis/diagnosis
  • Laryngeal Muscles
  • Cross-Sectional Studies
  • Humans
  • Voice Quality
  • Vocal Cords


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