title: Unilateral Vocal Fold Paralysis: A Systematic Review of Speech-Language Pathology Management.
abstract: OBJECTIVE
  Dysphonia due to unilateral vocal fold paralysis (UVFP) can be characterized by hoarseness and weakness, resulting in a significant impact on patients' activity and participation. Voice therapy provided by a speech-language pathologist is designed to maximize vocal function and improve quality of life. The purpose of this paper is to systematically review literature surrounding the effectiveness of speech-language pathology intervention for the management of UVFP in adults.
  
  
  METHODS
  This is a systematic review.
  
  
  METHODS
  Electronic databases were searched using a range of key terms including dysphonia, vocal fold paralysis, and speech-language pathology. Eligible articles were extracted and reviewed by the authors for risk of bias, methodology, treatment efficacy, and clinical outcomes.
  
  
  RESULTS
  Of the 3311 articles identified, 12 met the inclusion criteria: seven case series and five comparative studies. All 12 studies subjectively reported positive effects following the implementation of voice therapy for UVFP; however, the heterogeneity of participant characteristics, voice therapy, and voice outcome resulted in a low level of evidence.
  
  
  CONCLUSIONS
  There is presently a lack of methodological rigor and clinical efficacy in the speech-language pathology management of dysphonia arising from UVFP in adults. Reasons for this reduced efficacy can be attributed to the following: (1) no standardized speech-language pathology intervention; (2) no consistency of assessment battery; (3) the variable etiology and clinical presentation of UVFP; and (4) inconsistent timing, frequency, and intensity of treatment. Further research is required to develop the evidence for the management of UVFP incorporating controlled treatment protocols and more rigorous clinical methodology.
authors.affiliation: Australian Catholic University, Sydney, Australia. Electronic address: chloe.walton@myacu.edu.au.
authors.forename: Chloe
authors.initials: C
authors.lastname: Walton
authors.affiliation: Australian Catholic University, Sydney, Australia.
authors.forename: Erin
authors.initials: E
authors.lastname: Conway
authors.affiliation: University College London, Royal National Throat, Nose and Ear Hospital, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Blackshaw
authors.affiliation: National Course Coordinator in Speech Pathology, Australian Catholic University, Sydney, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Carding
mesh_terms: D006801:Humans; D013066:Speech-Language Pathology / Q000379:methods*; D014826:Vocal Cord Paralysis / Q000628:therapy*
keywords: Speech pathology; Unilateral vocal fold paralysis; Voice therapy