Relationship between the Incidence of Vocal Cord Palsy and Aspiration Risk in Acute Ischemic Stroke Patients

ABSTRACT

OBJECTIVE: To investigate the incidence of vocal cord palsy (VCP) in acute ischemic stroke patients and its influence on aspiration risk. METHOD: Fifty patients with first-ever acute stroke were enrolled. The mean age was 68.3 years and there were 21 men and 29 women. Based on clinical and neuroimaging findings, their stroke subtype was categorized into cortical/ subcortical (Group A), lateral medulla (Group B) and other brainstem (Group C). We examined them by using flexible fiberoptic rhinolaryngoscope and videofluroscopic swallowing study (VFSS) within 2 weeks after stroke onset. The Penetration - Aspiration Scale (PAS) was used to score each VFSS. RESULTS: Among the 50 patients, VCP was found in 15 (30%) 15.8% of group A, 100% of group B and 40% of group C. VCP was contralateral to the brain lesion in group A and ipsilateral in 85.7% of group B. Aspiration risk was found in 38% of the all patients and 53% of VCP had aspiration risk. No differences in the incidence of aspiration risk were noted according to VCP (chi-square=2.138, p=0.144). CONCLUSION: There was no relationship between VCP and aspiration risk in acute ischemic stroke patients. Although VCP is a known risk factor for aspiration, other factors are important in determining an effective swallowing.