Effects of the “Smith Accent Technique” of voice therapy on the laryngeal functions and voice quality of patients with unilateral vocal fold paralysis

2003 ◽  
Vol 1240 ◽  
pp. 1235-1241 ◽  
Author(s):  
Aliaa Khidr
2002 ◽  
Vol 111 (6) ◽  
pp. 523-529 ◽  
Author(s):  
Petri Reijonen ◽  
Sari Lehikoinen-Söderlund ◽  
Heikki Rihkanen

The objective of this study was to evaluate the effects on voice quality of augmentation by injection of minced fascia in patients with unilateral vocal fold paralysis. Preoperative and postoperative voice samples from 14 patients (6 men and 8 women; mean age, 59 years) were analyzed by computerized acoustic analysis and blinded perceptual evaluation. Statistically significant improvements were seen in perturbation measurements (jitter and shimmer), noise-to-harmonics ratio, and maximum phonation time. A panel of evaluators rated 10 of the 14 postoperative voices as normal or near-normal. Injection laryngoplasty with minced fascia offers a new, effective, well-tolerated, and inexpensive method to medialize a paralyzed vocal fold. The graft seems to survive well, as indicated by good vocal results with a follow-up ranging from 5 to 32 months.


2010 ◽  
Vol 125 (2) ◽  
pp. 173-180
Author(s):  
J Shi ◽  
S Chen ◽  
D Chen ◽  
W Wang ◽  
S Xia ◽  
...  

AbstractObjectives:(1) To evaluate the efficacy of modified arytenoid adduction in the management of patients with symptomatic cancer-related unilateral vocal fold paralysis, and (2) to assess the impact of this treatment on patients' quality of life.Methods:Forty-two patients with cancer-related unilateral vocal fold paralysis underwent modified arytenoid adduction between February 2001 and December 2008. Of these, 37 patients were enrolled in this retrospective study (one patient died of primary disease and four were lost to follow up). Laryngostroboscopy was performed to evaluate vocal fold orientation and mobility. Pre- and post-operative assessment of subjective and objective voice, aerodynamic parameters, and quality of life were also undertaken, and aspiration was subjectively rated.Results:Laryngostroboscopic findings indicated a significant post-operative improvement in vocal fold posterior glottal closure and vertical gap. Significant improvements in voice quality, aerodynamic parameters and quality of life were noted three months post-operatively in all patients (p < 0.01). The overall success rate for swallowing rehabilitation was 94.6 per cent (35/37). Subjective aspiration ratings decreased significantly post-operatively, compared with pre-operative values (p < 0.01). No major complication occurred in any patient, except for dyspnoea in one patient.Conclusion:Modified arytenoid adduction is an effective and reliable medialisation technique which can restore satisfactory voice quality, prevent aspiration and lead to a better quality of life for patients with cancer-related unilateral vocal fold paralysis.


2021 ◽  
pp. 019459982110151
Author(s):  
Cheng-Ming Hsu ◽  
Yao-Te Tsai ◽  
Geng-He Chang ◽  
Yao-Hsu Yang ◽  
Tuan-Jen Fang ◽  
...  

Objective To examine the association of laryngoplasty, voice therapy, and pneumonia rate in patients with unilateral vocal fold paralysis (UVFP). Study Design Population-based retrospective cohort study. Setting Data were collected from the LHID2000 (Longitudinal Health Insurance Database 2000), containing the information of 1 million randomly selected patients in Taiwan. Methods In the LHID2000, we identified 439 patients having new diagnoses of UVFP from 1997 to 2013. We grouped the aforementioned patients according to UVFP treatment and probed the occurrence of pneumonia: 305 patients underwent laryngoplasty or voice therapy, and 134 patients did not undergo treatment. Follow-up procedures were executed for the enrollees until death or December 31, 2013, representing the end of the study period. We assessed the association of UVFP treatment and pneumonia by executing Cox proportional hazards regression. Results The pneumonia cumulative incidence was significantly higher among enrolled patients without treatment than in those receiving treatment ( P < .001). The pneumonia incidence was significantly lower in patients receiving UVFP treatment (hazard ratio, 0.49; 95% CI, 0.27-0.88; P = .018), as validated by the Cox proportional hazards model after adjustment. Patients undergoing laryngoplasty with or without voice therapy had a significantly lower incidence of pneumonia at 6 months and 1, 3, and 5 years, whereas those undergoing voice therapy alone did not. Conclusion Laryngoplasty was associated with a lower incidence of short- and long-term pneumonia in patients with UVFP. Physicians should encourage patients with UVFP at risk of aspiration to receive prompt evaluation as well as treatment.


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Yung-An Tsou ◽  
Yi-Wen Liu ◽  
Wen-Dien Chang ◽  
Wei-Chen Chen ◽  
Hsiang-Chun Ke ◽  
...  

Objective.Autologous fat injection laryngoplasty is ineffective for some patients with iatrogenic vocal fold paralysis, and additional laryngeal framework surgery is often required. An acoustically measurable outcome predictor for lipoinjection laryngoplasty would assist phonosurgeons in formulating treatment strategies.Methods.Seventeen thyroid surgery patients with unilateral vocal fold paralysis participated in this study. All subjects underwent lipoinjection laryngoplasty to treat postsurgery vocal hoarseness. After treatment, patients were assigned to success and failure groups on the basis of voice improvement. Linear prediction analysis was used to construct a new voice quality indicator, the number of irregular peaks (NIrrP). It compared with the measures used in the Multi-Dimensional Voice Program (MDVP), such as jitter (frequency perturbation) and shimmer (perturbation of amplitude).Results.By comparing the [i] vowel produced by patients before the lipoinjection laryngoplasty (AUC = 0.98, 95% CI = 0.78–0.99), NIrrP was shown to be a more accurate predictor of long-term surgical outcomes than jitter (AUC = 0.73, 95% CI = 0.47–0.91) and shimmer (AUC = 0.63, 95% CI = 0.37–0.85), as identified by the receiver operating characteristic curve.Conclusions.NIrrP measured using the LP model could be a more accurate outcome predictor than the parameters used in the MDVP.


2017 ◽  
Vol 3 ◽  
pp. 277-284 ◽  
Author(s):  
Ewelina M. Sielska-Badurek ◽  
Maria Sobol ◽  
Katarzyna Jędra ◽  
Anna Rzepakowska ◽  
Ewa Osuch-Wójcikiewicz ◽  
...  

2011 ◽  
Vol 36 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Francesco Mattioli ◽  
Giuseppe Bergamini ◽  
Matteo Alicandri-Ciufelli ◽  
Gabriele Molteni ◽  
Maria P. Luppi ◽  
...  

2012 ◽  
Vol 22 (3) ◽  
pp. 112-120 ◽  
Author(s):  
Sarah L. Schneider

Purpose: In this article, I will summarize the process of selecting appropriate voice therapy candidates and relevant treatment techniques for patients with unilateral vocal fold paralysis or paresis. Methods: I will present a review of the literature and pertinent clinical experience while laying out diagnostic tools, considerations for choosing voice therapy candidates, and specific therapy techniques that clinicians may employ. In addition, I highlight how these decisions are guided by a thorough behavioral diagnostic voice evaluation. Results: There are a number of publications in the literature that discuss the role of voice therapy and the types of voice therapy techniques commonly used in treating vocal fold motion impairment. However, little efficacy data exist about the utility of voice therapy alone in this population. Conclusions: Behavioral management of patients with vocal fold paralysis and paresis is widely accepted as part of the treatment process. With little efficacy data to support outcomes for specific voice therapy techniques alone with this patient population, we must continue to rely primarily on our clinical experience and outcomes from other populations to guide the therapeutic process.


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