Unilateral vocal fold paralysis post-thyroidectomy: does early intervention allow for better voice recovery?

Abstract

OBJECTIVE:

Thyroidectomy is the primary cause of unilateral vocal fold paralysis (UVFP). A delay in rehabilitation may cause dysfunctional phenomena and worsen dysphonia. The main aim is to investigate the impact of early Speech Therapy (ST) on voice recovery in UVFP post-thyroidectomy and propose an appropriate treatment schedule.

PATIENTS AND METHODS:

93 patients with UVFP were analysed. 72 presented transient paralysis and 21 permanent ones. Individuals with permanent paralysis were retrospectively divided in two groups. Group A was composed of 11 patients (8 F, 3 M; mean age: 50.5 ± 8.6) who received ST within 8 weeks; Group B comprised 10 patients (7 F, 3 M; mean age: 57 ± 11.5) treated after more than 8 weeks. Videolaryngostroboscopy (VLS) was assessed and both objective and subjective voice parameters were collected. The non-parametric Wilcoxon test was applied to the sample.

RESULTS:

The resolution of supraglottic compensations was observed in 91% of cases in Group A, whereas in only 40% of cases in Group B. A functional glottal closure occurred in 73% of patients in group A, while it was completely absent in group B. Group A showed a statistically significant difference between the values of Jitter, NHR, TMF and VHI collected pre-ST compared to that collected after 1 year. Conversely, a statistically significant difference was found only for VHI values in group B.

CONCLUSIONS:

Early ST brings benefits to patients with permanent UVFP, both on voice recovery and on quality of life. A ST protocol should be applied both before and after thyroidectomy. The ST treatment should start early after surgery.

• Authors: G Ruoppolo, L Mariani, S Quaglieri, L Longo, P Pescerelli, A Cilfone, C Cocchi, D Marcotullio, A Greco, M De Vincentiis
• Journal: European review for medical and pharmacological sciences (Eur Rev Med Pharmacol Sci) Vol. 25 Issue 3 Pg. 1177-1184 (02 2021) ISSN: 2284-0729 [Electronic] Italy
• PMID: 33629287 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Recovery of Function
• Thyroidectomy
• Vocal Cord Paralysis (therapy)
• Vocal Cords
• Young Adult