title: The role of early voice therapy in the incidence of motility recovery in unilateral vocal fold paralysis.
abstract: OBJECTIVES. Vocal fold paralysis can have a significant impact on a patient's quality of life. The aim of this study was to analyze, in terms of vocal improvement and motility recovery, the post-vocal treatment results of patients with unilateral vocal fold paralysis (UVFP) who underwent early voice therapy. Study design. A 7 years prospective study of patients with an UVFP who underwent our multidimensional diagnostic-therapeutic assessment. MATERIAL AND METHODS. Seventy-four patients with UVFP were included in the study. All patients underwent a voice therapy based on forcible exercises supplemented by manipulations and maneuvers. A pre and post-treatment objective voice evaluation and self-assessment was made.
  
  
  RESULTS
  Out of 74 patients with UVFP, 51 (68.9%) recovered vocal fold motility. In 23 (31.1%), UVFP persisted after voice therapy. In this group of patients, a complete glottal closure was seen in 5 before voice therapy and in 13 after; An important and significant (p <0.0001) reduction in fundamental frequency (F(o)) was found; a manifest improvement was seen for the mean values of Jitter (Jitt%; p = 0.001), Shimmer (Shim%; p <0.0001) and noise-to-harmonic ratio (NHR) (p <0.0001). The same statistical comparisons calculated for male patients alone was not significant for Jitt% (0.102), Shim% (0.112) and NHR (0.155), as a result of the reduced number of patients in this group. Voice Handicap Index (VHI) values showed a clear and significant improvement and mean maximum phonation time (MPT) increased significantly. CONCLUSION. Early voice therapy based on an energetic approach, combined with patient co-operation, motivation and understanding through educated participation in the voice restoration process, strengthen the idea that patients with UVFP have a good chance of recovering vocal fold motility or improving their voice quality.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mattioli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bergamini
authors.forename: Matteo
authors.initials: M
authors.lastname: Alicandri-Ciufelli
authors.forename: Gabriele
authors.initials: G
authors.lastname: Molteni
authors.forename: Maria P
authors.initials: MP
authors.lastname: Luppi
authors.forename: Federica
authors.initials: F
authors.lastname: Nizzoli
authors.forename: Alberto
authors.initials: A
authors.lastname: Grammatica
authors.forename: Livio
authors.initials: L
authors.lastname: Presutti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014827:Vocal Cords / Q000503:physiopathology*; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult