Laryngeal
synkinesis is a vocal fold
movement disorder produced by a misdirected reinnervation after a
recurrent laryngeal nerve injury. Its symptoms differ greatly between patients, requiring diverse therapeutical approaches. We aim to describe our experience in the diagnosis and treatment of different laryngeal
synkinesis presentations. 11 patients diagnosed between 2011 and 2014 in a tertiary referral center with laryngeal
synkinesis confirmed by laryngeal electromyography were included in our study. All medical records and laryngoscopic and electromyographic data were reviewed retrospectively. Four patients had previous unilateral
vocal fold palsy and seven had a bilateral
palsy with different degrees of clinical involvement. All of them showed paradoxical movements during inhalation in videofibrolaryngoscopic examination. Laryngeal electromyography confirmed the diagnosis of laryngeal
synkinesis.
Dyspnea was the main presentation symptom. Three patients with mild symptoms were not treated. Patients with unilateral vocal fold immobility were successfully treated with periodic
botulinum toxin injections. Patients with bilateral immobility had a good initial response to
botulinum toxin, although in some of them, a posterior cordectomy had to be finally performed. In conclusion, laryngeal
synkinesis is a heterogeneous clinic entity that appears in patients with unilateral or bilateral vocal fold
paralysis. Videofibrolaryngoscopy and laryngeal electromyography are essential to a correct diagnosis.
Botulinum toxin injections are the main treatment for symptomatic cases, even if in bilateral
palsy cases more aggressive treatments are often required.