Behavioral Management of Unilateral Vocal Fold Paralysis and Paresis

2012 ◽  
Vol 22 (3) ◽  
pp. 112-120 ◽  
Author(s):  
Sarah L. Schneider
Keyword(s):  
Clinical Experience ◽  
Vocal Fold ◽  
Therapeutic Process ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Diagnostic Tools ◽  
Unilateral Vocal Fold Paralysis ◽  
Behavioral Management ◽  
Efficacy Data ◽  
Treatment Techniques

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.

Reduction in Short- and Long-term Pneumonia Rate With Laryngoplasty for Unilateral Vocal Fold Paralysis

2021 ◽  
pp. 019459982110151
Author(s):  
Cheng-Ming Hsu ◽  
Yao-Te Tsai ◽  
Geng-He Chang ◽  
Yao-Hsu Yang ◽  
Tuan-Jen Fang ◽  
...  
Keyword(s):  
Lower Incidence ◽  
Vocal Fold ◽  
Proportional Hazards ◽  
Vocal Fold Paralysis ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis ◽  
Short And Long Term

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.

The role of early voice therapy in the incidence of motility recovery in unilateral vocal fold paralysis

2011 ◽  
Vol 36 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Francesco Mattioli ◽  
Giuseppe Bergamini ◽  
Matteo Alicandri-Ciufelli ◽  
Gabriele Molteni ◽  
Maria P. Luppi ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Unilateral Vocal Fold Paralysis

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

2007 ◽  
Vol 122 (9) ◽  
pp. 936-941 ◽  
Author(s):  
L D'Alatri ◽  
S Galla ◽  
M Rigante ◽  
O Antonelli ◽  
S Buldrini ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Profile Analysis ◽  
Functional Results ◽  
Behavioural Therapy ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Rehabilitation Service ◽  
Unilateral Vocal Fold Paralysis ◽  
Behavioural Treatment ◽  
Mean Values

AbstractObjective:To evaluate the functional results obtained after voice therapy in patients with unilateral vocal fold paralysis caused by different aetiologies.Design: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.Results: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).Conclusions:Early voice therapy may enable significant improvement in vocal function, allowing the patient to avoid surgery.

Unilateral Vocal Fold Paralysis

1991 ◽  
Vol 1 (1) ◽  
pp. 45-48 ◽  
Author(s):  
Stephen C. McFarlane ◽  
Teri L. Holt-Romeo ◽  
Alfred S. Lavorato ◽  
Lyle Warner
Keyword(s):  
Vocal Fold ◽  
Vocal Fold Paralysis ◽  
Voice Therapy ◽  
Recurrent Laryngeal Nerve Paralysis ◽  
Unilateral Vocal Fold Paralysis ◽  
Point Scale ◽  
Speech Language Pathologists ◽  
Nerve Paralysis ◽  
Muscle Nerve ◽  
Normal Adults

Voice samples of 16 adult patients with vocal fold paralysis and 6 normal adults were recorded and evaluated by 27 listeners (9 speech-language pathologists, 9 otolaryngologists, and 9 lay listeners). The listeners rated the voices of the speakers on a 10-point scale on six vocal parameters (pitch, loudness, hoarseness, vocal roughness, breathiness, and overall quality). The 16 patients represented three different treatment approaches (teflon injection, 4; voice therapy, 6; and muscle-nerve reinnervation surgery, 6). Voice therapy and muscle nerve reinnervation surgery were both rated more successful than teflon injection in terms of improvement from pretreatment to posttreatment voices for all six vocal parameters. Normal speakers’ voices were rated higher than the voices of any treatment group. Speech-language pathologists were more reliable listeners than the other two listener groups. A case is made for using a period of trial voice therapy while waiting for possible spontaneous nerve healing in unilateral vocal fold paralysis patients who do not have aspiration problems and who have a competent cough. The majority of patients studied presented with unilateral recurrent laryngeal nerve paralysis, and none recovered vocal fold function during the course of the study.

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