Change in Voice Quality with Voice Therapy, Injection Laryngoplasty, and Medialization Thyroplasty

Introduction: In patients with unilateral vocal fold paralysis (UVFP), voice therapy (VT), injection laryngoplasty (IL), and medialization thyroplasty (MT) are reported to produce significant improvement in voice quality (VQ). However, their long-term outcomes have not been sufficiently evaluated. We assessed the improvement in VQ with VT, IL, and MT over ۱۲ months. Materials and Methods: This prospective observational study involved ۹۵ adult patients with UVFP, categorized into three groups: VT (n=۵۵), IL (n=۳۶), and MT (n=۴). The VQ was assessed with voice handicap index (VHI), maximum phonation time (MPT), phonatory gap (PG), and breathy voice quality (BVQ) on Day ۱, ۱۵, ۳۰, ۹۰, ۱۸۰, and ۳۶۰. Results: In the VT group, the decrease in PG, VHI score, and BVQ score was significant from Day ۱۵, ۳۰, and ۳۰, respectively, while MPT increased significantly from Day ۱۵ (p<۰.۰۵). In the MT group, similar changes were observed; however, these changes were significant from Day ۱ (p<۰.۰۵). In both the groups, the lowest PG, VHI score, and BVQ score, and the highest MPT were attained on Day ۳۶۰. In the IL group, PG, VHI score, and BVQ score decreased significantly, and MPT values increased significantly at every visit (p<۰.۰۵). However, PG, VHI score, and BVQ score started increasing and MPT started decreasing from Day ۹۰, ۱۵, ۹۰, and ۱۸۰, respectively. Conclusion: All treatment modalities improved the VQ significantly, immediately with IL and MT, and gradually with VT. Moreover, the improvement was long-term with VT and MT, and of intermediate duration with IL.

کلیدواژه ها:

Hyaluronic acid ، Injection laryngoplasty ، Medialization thyroplasty ، Unilateral vocal fold paralysis ، Voice therapy