Role of early voice therapy in patients affected by unilateral vocal fold paralysis

• Published in: Journal of laryngology and otology Vol. 122; no. 9; pp. 936 - 941
• Main Authors: D'Alatri, L, Galla, S, Rigante, M, Antonelli, O, Buldrini, S, Marchese, M R
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.09.2008
• Subjects: Abdomen; Adult; Aged; Biological and medical sciences; Diseases of the upper aerodigestive tract; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Ent and stomatology; Exercise; Falsetto; Female; Humans; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurology; Non tumoral diseases; Otorhinolaryngology. Stomatology; Patients; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrent Laryngeal Nerve; Speech Acoustics; Speech Therapy; Speech Therapy - methods; Surgery; Time Factors; Treatment Outcome; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Vocal Cord Paralysis; Vocal Cord Paralysis - physiopathology; Vocal Cord Paralysis - therapy; Voice Disorders; Voice Quality; United States > US; Vocal Cord Paralysis; Voice Disorders; Speech Therapy; Recurrent Laryngeal Nerve; Human; ENT; Language disorder; Communication disorder; Orthophony; Vocal cord paralysis; Treatment; Unilateral; ENT disease; Dysphonia; Early; Larynx disease; Voice; Recurrent laryngeal nerve
• ISSN: 0022-2151; 1748-5460
• DOI: 10.1017/S0022215107000679

To evaluate the functional results obtained after voice therapy in patients with unilateral vocal fold paralysis caused by different aetiologies. Prospective analysis of the outcome of unilateral vocal fold paralysis cases treated at our speech and language rehabilitation service from November 2003 to January 2006. Thirty cases underwent behavioural treatment, between two and six weeks after unilateral vocal fold paralysis onset. A multi-dimensional assessment was carried out before, immediately after and six months after treatment. After behavioural therapy, the prevalence of complete glottal closure increased significantly (p < 0.05). Subjects' pre-therapy mean values for jitter, shimmer and noise-to-harmonic ratio were statistically significantly different from those taken both immediately and six months after treatment (p < 0.05). The mean values for voice turbulence index significantly improved only six months after therapy (0.08 vs 0.04). At both post-treatment assessments, voice range profile analysis showed a significant decrease of lowest voice frequency and a significant increase of the number of semitones (p < 0.05). Mean values for grade, instability, breathiness, asthenia and voice handicap index scores were significantly decreased both immediately and six months after treatment, compared with pre-treatment values (p < 0.05). Early voice therapy may enable significant improvement in vocal function, allowing the patient to avoid surgery.