On the problem of voice rehabilitation in the case of unilateral vocal fold paresis

• Published in: Vestnik otorinolaringologii Vol. 81; no. 5; p. 67
• Main Author: Shilenkova, V V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2016
• Subjects: Adult; Breathing Exercises - methods; Combined Modality Therapy - methods; Conservative Treatment - methods; Electric Stimulation Therapy - methods; Female; Humans; Male; Middle Aged; Myofunctional Therapy - methods; Quality of Life; Recovery of Function; Speech Therapy - methods; Treatment Outcome; Vocal Cord Paralysis - complications; Vocal Cord Paralysis - diagnosis; Vocal Cord Paralysis - physiopathology; Vocal Cord Paralysis - rehabilitation; Voice Disorders - diagnosis; Voice Disorders - etiology; Voice Disorders - psychology; Voice Disorders - therapy
• ISSN: 0042-4668
• DOI: 10.17116/otorino201681567-72

Unilateral vocal fold paresis (UVFP) significantly deteriorates the patient's quality of life. The leading role in the rehabilitation of the patients presenting with UVFP belongs to stimulation therapy which consists in the activation of muscle re-innervation of the larynx and the compensatory mechanisms allowing to achieve the most complete closure of the vocal folds during phonation.
The objective of the present study was the optimization of the conservative treatment of patients with UVFP.
Fifty patients at the age varying from 18 to 70 years presenting with UVFP (the duration of the disease less than 6 months underwent the comprehensive treatment including electrostimulation of the larynx, vitamin therapy, and speech therapy. The patients were divided into two groups: A and B comprised of 25 subjects each. Those of Group A were given, in addition to the standard treatment, a 1.5 month-long course of Neuromidin therapy. The results of the treatment were evaluated with the use of laryngostroboscopy, flowmetry, the GRBAS scale, acoustic voice analysis (lingWaves), and the VHI questionnaire.
The restoration of vocal fold mobility was achieved in 20% and 8% of the patients of groups A and B respectively. The clinical effect was absent in 12% of the patients in Group A and 28% of the patients in Group B. The differences between groups were statistically significant (p<0.05). In the remaining cases, the positive dynamics of the flowmetric characteristics, GRBAS and VHI data, maximum phonation time, Jitter, DSI, frequency and dynamic ranges as well as the intensity of voice were documented in 68% of patients in Group A and 64% of patients in Group B).
The results of the study confirm the usefulness of the combined treatment of UVFP consisting of electrostimulation of the larynx together with speech therapy and application of cholinergic drugs. The addition of Neuromidin to the conventional scheme of conservative treatment can further improve its efficiency from 72% to 88%.