Vocal fold paralysis in individuals undergoing esophagectomy for cancer: integrative review

Introduction: Vocal fold paralysis is a possibility in patients treated for esophageal cancer, which has not yet been studied. It may be due to both tumor invasion of the laryngeal nerves and the surgical treatment modality. Objective: This integrative review aims to survey what has been published about vocal changes and vocal fold paralysis after esophagectomy. Methods: To select the articles, the databases Medical Literature Analysis and Retrieval System (MEDLARS), Latin American and Caribbean Health Science Literature (LILACS) and PubMed were used. Two independently review authors screened the abstracts and potentially eligible articles were read in full to determine eligibility. Results: a total of 96 records were identified after excluding duplicates. Thirty-eight titles and abstracts were selected for reading and eligibility. Of these, 7 studies were included in the final integrative review. It was observed that there is immobility of the vocal folds after esophagectomy ranging between 1.96% and 42.4% and that the incidence tends to be more frequent in patients undergoing cervical approaches and with a reduced body mass index, and tends to be less common when nerve dissection is performed by a specialized surgeon. Conclusions: Patients undergoing esophagectomy for cancer with vocal fold paralysis presented a reduction in maximum phonation time and an increase in air flow during phonation, in addition to a higher incidence of pneumonia, medical complications, tracheostomy, longer hospital stay, more hospital expenses and the need for more outpatient speech therapy evaluations. None of the studies provide data on auditory-perceptual or acoustic parameters of the vocal quality of these individuals, although they present vocal complaints.