Longitudinal Voice Outcomes After Voice Therapy in Unilateral Vocal Fold Paralysis

Abstract

Objectives: To investigate the long-term effectiveness of voice therapy in vocal outcomes of patients with unilateral vocal fold paralysis (UVFP) and vocal productions of patients with long-standing treatment-naïve UVFP treated with voice therapy.

Study design: Prospective observational study.

Methods: A voice therapy protocol was applied individually in three stages. Fifteen sessions were scheduled twice a week in 70 patients with UVFP. Forty-seven patients were treated within a year of the diagnosis (group 1). The remaining patients had delayed therapy (at least 1 year after diagnosis) (group 2). Multidisciplinary assessment included nasofibroscopy, videostroboscopy, acoustic and aerodynamic parameters, and perception of voice impairment measures. A subgroup of the 70 patients (n = 32) was reassessed after 1 year of follow-up.

Results: Our voice therapy protocol significantly improved voice productions and perception of voice impairment in group 1 (P < 0.0001). Patients in group 2 experienced less hoarseness and had improved perception of voice impairment (P = 0.007). The improvement was long lasting and persisted at 1 year of follow-up in both groups.

Conclusions: Voice therapy is effective in patients with UVFP and its benefits are sustained over time. Early referral for voice therapy seems to be associated with greater benefit, but quality of life also improves for patients despite delayed treatment.

Keywords: Dysphonia; Speech therapy; Unilateral vocal fold paralysis; Voice pathology; Voice therapy.