Oral Reading Task with Selected Indices to Evaluate Speaking Voice Function in Patients with Unilateral Vocal Fold Paralysis before and after Surgical Interventions

Abstract Objective To evaluate voice intensity as the primary outcome measurement when treating unilateral vocal fold paralysis patients. Methods This prospective observational study comprised 34 newly diagnosed unilateral vocal fold paralysis patients undergoing surgical interventions: injection laryngoplasty or medialisation thyroplasty. Voice assessments, including maximum vocal intensity and other acoustic parameters, were performed at baseline and at one and three months post-intervention. Maximum vocal intensity was also repeated within two weeks before any surgical interventions were performed. The results were compared between different time points and between the two intervention groups. Results Maximum vocal intensity showed high internal consistency. Statistically significant improvements were seen in maximum vocal intensity, Voice Handicap Index-10 and other acoustic analyses at one and three months post-intervention. A significant moderate negative correlation was demonstrated between maximum vocal intensity and Voice Handicap Index-10, shimmer and jitter. There were no significant differences in voice outcomes between injection laryngoplasty and medialisation thyroplasty patients at any time point. Conclusion Maximum vocal intensity can be applied as a treatment outcome measure in unilateral vocal fold paralysis patients; it can demonstrate the effectiveness of treatment and moderately correlates with self-reported outcome measures.

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Tomographic Assessment of the Arytenoid Body in Unilateral Vocal-Fold Paralysis before and after Lateral Cricoarytenoid Muscle-Pull Surgery.

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.48.310 ◽

1997 ◽

Vol 48 (4) ◽

pp. 310-320

Author(s):

Shinobu Iwamura ◽

Yasuko Murakawa

Keyword(s):

Vocal Fold ◽

Vocal Fold Paralysis ◽

Unilateral Vocal Fold Paralysis ◽

Before And After

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Comparative study of framework surgery and fat injection laryngoplasty

The Journal of Laryngology & Otology ◽

10.1017/s0022215109005064 ◽

2009 ◽

Vol 123 (S31) ◽

pp. 35-41 ◽

Cited By ~ 16

Author(s):

H Umeno ◽

S Chitose ◽

K Sato ◽

T Nakashima

Keyword(s):

Comparative Study ◽

Vocal Fold ◽

Acoustic Analysis ◽

Functional Results ◽

Vocal Fold Paralysis ◽

Injection Laryngoplasty ◽

Unilateral Vocal Fold Paralysis ◽

Fat Injection ◽

Autologous Fat ◽

Before And After

AbstractObjective:To evaluate differences between the functional results of framework surgery and autologous fat injection laryngoplasty, for patients with unilateral vocal fold paralysis.Study design:Sixty-two patients underwent framework surgery, while 64 received autologous fat injection laryngoplasty. Voice function before and after both procedures was assessed using aerodynamic and acoustic analysis, with differences evaluated using paired t-test in both groups.Results:In both groups, all parameters improved significantly after surgery, compared with before surgery. Post-operative improvement in all parameters was significantly greater after fat injection laryngoplasty, compared with framework surgery.Conclusion:Autologous fat injection laryngoplasty was thus found to be a more effective and reliable therapy for improving voice function in patients with vocal fold paralysis, compared with framework surgery.

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Role of Medialization in the Improvement of Breath Control in Unilateral Vocal Fold Paralysis

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940211101114 ◽

2002 ◽

Vol 111 (11) ◽

pp. 1026-1033 ◽

Cited By ~ 22

Author(s):

Sophie Périé ◽

Géraldine Chaigneau-Debono ◽

Bernard Roubeau ◽

Magali Bruel ◽

Isabelle Liesenfelt ◽

...

Keyword(s):

Respiratory Function ◽

Vocal Fold ◽

Vocal Fold Paralysis ◽

Unilateral Vocal Fold Paralysis ◽

Mean Flow ◽

Respiratory Dysfunction ◽

Maximum Phonation Time ◽

Before And After ◽

Breath Control

A prospective study was performed on 18 adults to analyze disturbances of voice and respiratory function in unilateral vocal fold paralysis and the role of medialization in the improvement of breath control. In addition to physical examination, an acoustic and aerodynamic analysis, as well as patient self-assessment, were performed both before and after medialization (14 fat injections, 4 thyroplasties) to evaluate voice and both phonatory breath control and respiratory function outcome. Preoperative and postoperative results, at short, middle, and long term, were compared to data from 14 control subjects and evaluated by statistical analysis. Preoperative acoustic and aerodynamic parameters were significantly disturbed in comparison to controls. Independently of the pulmonary status, medialization induced an improvement in most of the parameters at short and long terms, whereas a diminished effect was observed at middle term. Phonatory breath control, as evaluated by maximum phonation time, mean flow rate, and expired volume, was statistically improved, with the best results being obtained in women. From the questionnaire, it was clear that voice, as well as phonatory breath control and respiratory function, showed considerable improvement, although some difficulties persisted during effort. This study demonstrates that there is a disturbance of phonatory breath control and respiratory function in adult unilateral vocal fold paralysis. Improvement following medialization supports the concept that the respiratory dysfunction seen beforehand is most probably the result of air escape rather than laryngeal obstruction. Although medialization may provoke an extrathoracic obstruction, its feature of variability appears to improve breath control.

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Voice and Laryngeal Configuration of Men With Unilateral Vocal Fold Paralysis Before and After Medialization

Journal of Voice ◽

10.1016/j.jvoice.2010.07.010 ◽

2010 ◽

Cited By ~ 2

Author(s):

Karine Schwarz ◽

Carla Aparecida Cielo ◽

Nédio Steffen ◽

Jéfferson Becker ◽

Geraldo Pereira Jotz

Keyword(s):

Vocal Fold ◽

Vocal Fold Paralysis ◽

Unilateral Vocal Fold Paralysis ◽

Before And After

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Unilateral Vocal Fold Paralysis and Voice Therapy: Does Age Matter? A Prospective Study With 100 Consecutive Patients

Ear Nose & Throat Journal ◽

10.1177/0145561319882116 ◽

2019 ◽

pp. 014556131988211 ◽

Cited By ~ 1

Author(s):

Mariline Santos ◽

Susana Vaz Freitas ◽

Pedro Santos ◽

Isabel Carvalho ◽

Miguel Coutinho ◽

...

Keyword(s):

Vocal Fold ◽

Cross Sectional Study ◽

Vocal Fold Paralysis ◽

Voice Therapy ◽

Unilateral Vocal Fold Paralysis ◽

Self Assessment ◽

Cross Sectional ◽

Recent Onset ◽

Before And After ◽

A Prospective Study

Objective: To use a multidimensional assessment to analyze potential influence of “aging” in the functional outcomes achieved by a group of patients with recent onset of unilateral vocal fold paralysis (UVFP) who underwent voice therapy. Design: Prospective, observational, and cross-sectional study. Setting: Otolaryngology department, Centro Hospitalar do Porto. Participants: Patients with UVFP who underwent voice therapy. Main Outcome Measures: Data regarding gender, age, side and position of the paralyzed vocal fold, etiology, comorbidities, and Voice Handicap Index (VHI)—30 questions, before and after voice therapy, were collected. Glottal insufficiency was also evaluated, by endoscopic laryngoscopy, before and after voice therapy. Results: A total of 100 patients (76 females and 24 males) with UVFP were included. Mean age was 61.04 years (range: 21-88 years). The mean score of VHI, before and after voice therapy, was statistically different ( P < .001) with a lower score after therapy. The score of VHI was not influenced by age ( P = .717). However, for each 10-year increase in age, the score of VHI, before and after voice therapy, increased 1.91 and 2.86 units, respectively. As concerns endoscopic findings, 80% of patients exhibited better glottis closure after voice therapy ( P < .001), and this was not influenced by age. Nevertheless, for each 10-year increase in age, the chance of endoscopic improvement reduced 3%. Conclusions: A clear and significant improvement was visible in the endoscopic and self-assessment ratings after rehabilitation by isolated voice therapy. Despite possible anatomical and physiological aging changes in the phonatory system, age did not compromise the successful rate obtained by voice therapy.

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