Current trends in the surgical treatment of unilateral vocal fold paralysis: A comparative survey of Korea, Japan and Taiwan

Background/objective Unilateral vocal fold paralysis (UVFP) significantly affects voice, swallowing, and airway protection. Although the fundamental principles of surgical treatment are consistent, actual clinical practices vary among countries. However, current practice patterns in East Asia have not been well documented. Therefore, this study aimed to describe and compare surgical treatment practices for UVFP among otorhinolaryngologists in Korea, Japan, and Taiwan. Methods A cross-sectional Internet-based survey was conducted in Korea, Japan, and Taiwan. An online questionnaire was distributed through professional networks between October and November 2024, and 119 otorhinolaryngologists participated. In addition, a systematic literature search was performed to analyze recent research trends in surgical treatments for UVFP across the three countries. Results Notable regional differences were observed in treatment preferences. Injection laryngoplasty was the most commonly recommended first-line treatment in Korea and Taiwan, whereas Japan had a stronger preference for laryngeal framework surgery, particularly medialization thyroplasty and arytenoid adduction. As with clinical practices, Korea and Taiwan demonstrated similar research interest in injection laryngoplasty, while Japan emphasized laryngeal framework surgery in its research output. Differences in healthcare systems, surgical training, regulatory requirements, and cost structures were identified as possible factors contributing to these variations. Conclusion This study provides a comprehensive overview of the current UVFP surgical practices in East Asia and highlights the influence of surgeon training, health system governance, economic resources, and cultural context on clinical decision-making. Further multinational studies are warranted to evaluate the long-term outcomes and cost-effectiveness of UVFP treatment strategies.