Discussion
The correct diagnosis of a vocal cord movement abnormality is vital to
help guide management of the patient, with potential medicolegal
implications if misdiagnosed. There are many causes of abnormal
movement, with movement ranging from fully mobile, paresis to complete
paralysis. Ideally clinical assessment would result in a reliable five
category scale to allow use in the range of clinical situations such as
reduction in movement in early invasive cancer or post thyroid surgery.
Although the present gold standard for assessing the movement of a vocal
cord is flexible nasendoscopy, there are few published studies assessing
the consistency between different raters.