Voice therapy for laryngeal hemiplegia : the role of timing of initiation of therapy

Laryngeal hemiplegia, also known as vocal fold paralysis, causes severe communicative disability. Although voice therapy is commonly considered to be beneficial for improving the voice quality in several voice disorders, there are only a few papers that present scientific evidence of the effectiveness of voice therapy in treating the disabilities of laryngeal hemiplegia. The aim of this study was to evaluate the outcomes of voice therapy in patients with laryngeal hemiplegia and to evaluate the role of the time gap between onset of laryngeal hemiplegia and initiation of therapy. Design: A prospective study comparing subjects treated either within or more than 3 months after the onset of laryngeal hemiplegia. Subjects: The study involved 30 laryngeal patients with hemiplegia (16 males, 14 females, age range 15-80 years). Methods: All patients underwent videolaryngostroboscopy, maximum phonation time measurement, GIRBAS perceptual evaluation, Voice Handicap Index self-assessment and Multi-Dimensional Voice Program voice analysis before and after therapy. Results: In all tests, there were significant improvements in voice quality, both in the group treated within 3 months after the onset of laryngeal hemiplegia and in the group treated after this time. Conclusion: Voice therapy is effective in treating laryngeal hemiplegia even if treatment is delayed by more than 3 months from onset of laryngeal hemiplegia.