The efficacy of early voice therapy in patients with vocal fold paralysis after thyroidectomy

The therapeutic effects of voice therapy, including relaxation exercises, semi-occluded vocal tract training, and vocal function strengthening exercises, have been studied in patients with vocal fold paralysis following thyroid surgery. However, optimal timing for initiating voice therapy remains unclear. This study aims to evaluate the effects and patient satisfaction associated with early voice therapy initiated within one month post-thyroidectomy in patients with unilateral vocal fold paralysis.

A retrospective review was conducted on 63 patients diagnosed with unilateral vocal fold paralysis after thyroidectomy. Thirty-two patients received early voice therapy within one month post-surgery (average of 3.5 sessions), while 31 patients did not receive any therapy. Comprehensive voice assessments, including laryngeal videostroboscopy, auditory-perceptual, acoustic, and aerodynamic evaluations, were performed preoperatively and at 2 weeks, 2 months, 6 months and 1 year post-surgery. Subjective voice satisfaction was assessed using the Thyroidectomy-related Voice and Symptom Questionnaire.

Preoperative analyses revealed a no significant differences between the two groups in most of the key voice outcomes, including the TVSQ.Voice therapy led to significant improvements in high pitch range (p=0.021), maximum phonation time (MPT) (p=0.006), and perceptual voice quality, and a reduction in throat discomfort. Furthermore, this group demonstrated a faster recovery to preoperative voice levels, in contrast to the non-therapy group, which experienced slower and incomplete recovery.

Early voice therapy following thyroidectomy is effective in enhancing vocal outcomes for patients with unilateral vocal fold paralysis, facilitating faster recovery and improved long-term voice function through enhanced glottic closure and pitch control.