title: Breathing and voice quality after surgical treatment for bilateral vocal cord paralysis.
abstract: OBJECTIVE
  To evaluate long-term results of surgical treatment for bilateral vocal cord paralysis using objective and subjective measures of breathing and voice quality.
  
  
  METHODS
  Prospective cross-sectional case series.
  
  
  METHODS
  Tertiary care otolaryngology and speech pathology referral center.
  
  
  METHODS
  Ten patients with bilateral vocal cord paralysis who underwent surgical treatment between October 1996 and May 2006 at the Department of Otorhinolaryngology-Head and Neck Surgery, University of Würzburg, were examined at a mean of 27.2 months after surgery.
  
  
  METHODS
  Glottal area, voice range profile, Voice Handicap Index, pulmonary function test results, Göttingen Hoarseness Diagram, microlaryngostroboscopic findings, chronic respiratory disease questionnaire, and European Organization for Research and the Treatment of Cancer quality-of-life questionnaire, including the head and neck module.
  
  
  RESULTS
  Residual recurrent nerve function was seen in 9 of 10 patients. Pulmonary data varied widely and did not correlate with the size of the glottal area. Quality of life, subjective dyspnea, and physical functioning correlated with expiratory airflow measures. Voice range was reduced in all patients. High breathiness and reduced maximum phonation time led to increased Voice Handicap Index scores.
  
  
  CONCLUSIONS
  Microlaryngostroboscopic findings did not necessarily correlate with subjective dyspnea and vocal complaints. Reduction of inspiratory speaking efforts and acquisition of special breathing techniques improve airflow stability and effectiveness of respiration, leading to enhanced quality of life.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University of Würzburg, Josef-Schneider Strasse 11, 97080 Würzburg, Germany. Wilma.Harnisch@uni-wuerzburg.de
authors.forename: Wilma
authors.initials: W
authors.lastname: Harnisch
authors.forename: Sibylle
authors.initials: S
authors.lastname: Brosch
authors.forename: Michael
authors.initials: M
authors.lastname: Schmidt
authors.forename: Rudolf
authors.initials: R
authors.lastname: Hagen
mesh_terms: D000328:Adult; D000368:Aged; D001945:Breathing Exercises; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012119:Respiration; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000503:physiopathology / Q000601:surgery*; D014831:Voice