Dysphonia in a Patient with Unilateral Plika Vocal Paresis


  • Melia Munasiah Universitas Lampung
  • Rizki Novtarina
  • Fivien Fedriani




dys[honia, paramedian vocal fold paralysis, unilateral vocal fold paralysis


Hoarse voice (dysphonia) is one of the reasons for consultation (1%) in all primary health services. Vocal cord paralysis is reduced movement or paralysis of the vocal cords. This situation is a manifestation of disease that occurs in the cranial cavity, larynx, thorax and mediastinum which causes paralysis of the vagus nerve and recurrent laryngeal nerve. Mr. I, a 56 year old male, came with complaints of sudden loss of voice. Complaints appeared 11 days before admission to the hospital (SMRS). Another complaint that is felt is that patients choke more easily when drinking. Complaints are felt to be getting worse day by day. The patient had previously been given antibiotics and anti-inflammatory drugs given at the puskesmas but there was no improvement either. The patient was previously hospitalized due to complaints of excessive vomiting. The patient's general status is within normal limits. LFO results showed adductor type unilateral paramedian vocal fold paralysis in the dextra paramedian position. The patient was given a physiotherapy plan and given steroids and vitamin B12. Voice therapy can be an effective treatment option in patients with unilateral paresis of the vocal folds and should be considered individualized according to the patient's age.

Author Biographies

Melia Munasiah, Universitas Lampung



Rizki Novtarina



Fivien Fedriani




Reiter R, Hoffmann TK, Pickhard A, Brosch S. Hoarseness-causes and treatments. Dtsch Arztebl Int. 2015 May 8;112(19):329-37. doi: 10.3238/arztebl.2015.0329. PMID: 26043420; PMCID: PMC4458789.

Gunawan, Kliwon, Soesyasmoro RA. Gangguan Suara. Klaten: Tahta Media. 2022.

Gupta, J., Varshney, S., Bist, SS., Bhagat, S. Clinico-Etiolological Study of Vocal Cord Paralysis. Indian J Otolaryngol Head Neck Surgery. 2013.65(1):16 – 1 9; DOI 10.1007/s12070-012-0574-x.

Al-khtoum, N., Al-momani, O., Shawakfeh, N., Al-Safadi, E., Hamasha, K. Acquired Unilateral Vocal Fold Paralysis:Retrospective analysis of a single institutional experience. North American Journal of Medical Sciences, 2013,5(12),699.doi:10.4103/1947-714.123254.

Timon, c., Cashman ec. Vocal Cord Paralysis. Logan Turner’s Diseases of The Nose, Throat and Ear Head and Neck Surgery. 2016, Eleventh edition, Hal 306.

Anil, HT., Raj, NL., Pillai, N. Original article : A Study on Etiopathogenesis of Vocal Cord Paresis and Palsy in a Tertiary Centre. Indian J Otolaryngol Head Neck Surgery.2018. https://doi.org/10.1007/s12070-018-1502-5

Blitzer A, Brin MF, Clark TJ, et al. (2020). Paralysis of the Larynx. Journal of Voice. 34(2):255-259. https://doi.org/10.1016/j.jvoice.2019.01.014.

Omayma E., Afsah. Approach to Diagnosis of Vocal Fold Immobility: a literature review. The Egyptian Journal of Otolaryngology 2015, 31:78 –9 1

Hermani B, Abdurrachman H, Cahyono A. Kelainan Laring. Buku Ajar Ilmu Kesehatan Telinga Hidung Tenggorok Kepala dan Leher. Ed 6. Jakarta;FKUI:2007:237-42.

Young, N., Simpson CB. Treatment of Vocal Fold Paralysis. Bailey’s Head and Neck Surgery-Otolaryngology [edited by] Jonas T. Johnson, Clark A Rosen. 5th ed. Philadelphia. 2014. Vol 1. Hal 1038.

Ludlow, CL., Bielamowicz, SA. Neurogenic Disorders of the Larynx. Ballenger’s OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY. 2009. Hal 923.

Omayma E., Afsah. Approach to Diagnosis of Vocal Fold Immobility: a literature review. The Egyptian Journal of Otolaryngology 2015, 31:78 –9 1.

Ballenger JJ. Disease of the Nose, Throat, Ear, Head and Neck. 13th Ed. Illinois;Lea and Febiger:1993.

Sumber sitasi: Gartner-Schmidt, J. L., Ziegler, A., Thibeault, S. L., & Rosen, C. A. A systematic review of treatment outcomes for unilateral vocal fold paralysis. Laryngoscope Investigative Otolaryngology. 2019;4(3):303-315. https://doi.org/10.1002/lio2.251)

. Rosen, C. A., Murry, T., Zullo, T., & Sonetti, D. Bilateral vocal fold injections: a longitudinal analysis of function and disease. The Laryngoscope. 2000;110(7): 1095-1099. doi: 10.1097/00005537-200007000-00007

Sulica, L., Rosen, C. A., Postma, G. N., Simpson, B., Amin, M. R., & Courey, M. Current practice in injection augmentation of the vocal folds: indications, treatment principles, techniques, and complications. Annals of Otology, Rhinology & Laryngology. 2016;125(6):453-462. doi: 10.1177/0003489416638538

Sethi, J. M., & Stanley, R. E. Injection laryngoplasty. Current Opinion in Otolaryngology & Head and Neck Surgery, (2014);22(6):466-470. doi: 10.1097/MOO.0000000000000095

Tokashiki, R., Higo, R., Mori, K., & Yumoto, E. The Efficacy of Vitamin B12 Injection in Patients With Vocal Fold Paresis. The Annals of Otology, Rhinology, and Laryngology. 2017;126(7): 503–508. https://doi.org/10.1177/0003489417690945

Saedi, B., Ghasemi, M. M., & Asghari, A. Effect of Oral Vitamin B12 Supplementation on the Treatment of Vocal Cord Paresis: A Double-Blind Clinical Trial. Journal of Voice. 2017;31(4):493.e9-493.e12. https://doi.org/10.1016/j.jvoice.2016.08.011

Rihkanen, H., Lehtonen, H., & Vilkman, E. Injectable hyaluronic acid gel for the treatment of glottal insufficiency: a prospective pilot study. Clinical Otolaryngology. 2004;29(2):105-110.

Wu, Y. H., Hsiao, T. Y., Liao, L. J., Huang, H. M., & Lin, Y. C. Botulinum toxin injections for unilateral vocal cord paralysis. Ear, Nose & Throat Journal. 2010;89(3): E1-E3

Laryngoscope Investigative Otolaryngology. Hydroxyapatite injection for vocal fold medialization in unilateral vocal fold paralysis: a systematic review. 2017; Dec;2(6):394-400. doi: 10.1002/lio2.109

Journal of Voice. Long-term Effects of Poly-L-Lactic Acid Injections in Unilateral Vocal Fold Paralysis. 2018;Mar;32(2):172-177. doi: 10.1016/j.jvoice.2017.01.013

Santos M, Vaz Freitas S, Santos P, Carvalho I, Coutinho M, Moreira da Silva Á, Almeida E Sousa C. Unilateral Vocal Fold Paralysis and Voice Therapy: Does Age Matter? A Prospective Study With 100 Consecutive Patients. Ear Nose Throat J. 2021; Sep;100(5_suppl):489S-494S. doi: 10.1177/0145561319882116. Epub 2019 Oct 17. PMID: 31619079.

Sulica L, Rosen CA. Unilateral vocal fold paralysis. Otolaryngol Clin North Am. 2015 Apr;48(2):189-213. doi: 10.1016/j.otc.2014.11.004. PMID: 25701907.

Kim CH, Park JJ, Kim YH, Park KN. Spontaneous recovery of idiopathic vocal fold paralysis. Laryngoscope. 2017;127(9):2129-2132. doi:10.1002/lary.26509

Nito T, Araki K, Ishii H, et al. Spontaneous recovery rate in patients with unilateral vocal cord paralysis. Auris Nasus Larynx. 2017;44(1):57-61. doi:10.1016/j.anl.2016.02.008

Hillel AT, Karatayli-Ozgursoy S, Samad M, Akst LM. Idiopathic unilateral vocal fold paralysis: is it time to revise our thinking? Ann Otol Rhinol Laryngol. 2012 Oct;121(10):630-6. doi: 10.1177/000348941212101008. PMID: 23193904.



How to Cite

Munasiah, M., Novtarina, R., & Fedriani, F. (2024). Dysphonia in a Patient with Unilateral Plika Vocal Paresis . Medical Profession Journal of Lampung, 14(5), 831-838. https://doi.org/10.53089/medula.v14i5.1065