engleski

Phonatory function and voice therapy of unilateral recurrent nerve paralysis

The first step in patient with diagnosis of unilateral recurrent nerve paralysis (RNP) is to determine the exact etiological mechanism because it can be an indicator of serious condition (e.g. laryngeal Ca). Stroboscopy, phonatory laryngeal tomography and EMG are important for differential diagnosis. The diagnostic procedure should be followed by voice and phonatory function analysis in order to start the adequate rehabilitation process. Phonatory function is investigated using digital endoscopic technology, acoustical analysis and aerodynamical tests ; all of which include manual laryngeal pressure medialisation to evaluate its effect on vocal fold adduction and phonation. Voice analysis should include subjective (through questionnaire fulfilled by every member of the phoniatric team treating a patient) and objective (using PRAAT computer program) evaluation. As already reported, we had three possible outcomes of unilateral RNP: spontaneous phonatory recovery, recovery after rehabilitation or absence of recovery despite rehabilitation. Further analyses of the latter group showed that majority of them possessed degeneration with glottic sulcus on the previously considered healthy vocal fold and some developed ventricular fold compensatory adduction that deteriorated the voice additionally. In such cases we suggest operative medialization that would result in satisfactory glottic adduction and therefore adequate laryngeal function.

vocal cord paralysis-diagnosis; voice training

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