Study Reveals Experts Disagree in the Clinical Diagnosis of Vocal Fold Paresis

A Sean Parker Institute study published in the September 2017 issue of The Laryngoscope (https://www.ncbi.nlm.nih.gov/pubmed/28349567 ) shows that expert consensus on stroboscopic diagnosis of paresis remains elusive. Laryngeal stroboscopic examination is by far the most common means used to diagnosis this entity. Agreement regarding the presence or absence of paresis in laryngeal video examinations among blinded raters was only moderate. Even less existed regarding the side and nerves involved. In exams which yielded high degrees of expert agreement, deficits of vocal fold motion were the most persuasive factor, in comparison to stroboscopic abnormalities, glottic insufficiency or loss of muscle bulk or tone. These results emphasize the subjective nature of the diagnosis, and indirectly, the importance of clinical context and ultimately, improved electrodiagnostic testing.