Implications of Synkinesis in Unilateral Vocal Fold Paralysis

Yu-Cheng Pei, Wei Han Chang, Hsiu Feng Chuang, Chia Fen Chang, Tuan-Jen Fang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

6 Scopus citations


Objectives: In patients with unilateral vocal fold paralysis (UVFP), laryngeal electromyography (LEMG) occasionally observes synkinesis in laryngeal muscles, a condition that could impair vocal fold mobility and voice control. This study aims to evaluate the impact of synkinesis on UVFP patients. Study Design: A retrospective case-control study. Setting: Medical center. Subjects and Methods: Patients with UVFP onset >6 months were recruited (N = 104). The outcome measurements included LEMG, quantitative LEMG analysis of thyroarytenoid–lateral cricoarytenoid (TA-LCA) muscle complex, glottal gap measured by videolaryngostroboscopy, voice-related quality of life, and voice acoustic analysis. Results: According to the LEMG analysis, 8 patients (8%) had synkinesis, and 96 (92%) did not. In the synkinesis group, TA-LCA turn frequency in the lesioned side was comparable to that in the healthy side (P =.52). Patients in the synkinesis group had higher TA-LCA turn frequency (P =.001), higher probability of cricothyroid muscle dysfunction (P =.04), and better voice-related quality of life (P =.01) but objective voice outcomes comparable to those in the nonsynkinesis group. Conclusions: Patients with synkinesis will have near-complete restoration in TA-LCA turn frequency but still experience voice impairment, a finding that is compatible with the mechanism of aberrant reinnervation. However, patients with synkinesis have better disease-related quality of life than do those without synkinesis.

Original languageEnglish
Pages (from-to)1017-1024
Number of pages8
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number6
StatePublished - 01 12 2017

Bibliographical note

Publisher Copyright:
© 2017, © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2017.


  • idiopathic
  • quantitative laryngeal electromyography
  • reinnervation
  • synkinesis
  • unilateral vocal fold paralysis
  • voice


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