Related Experiment Video
Updated: Sep 17, 2025

Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Voice Outcomes in Chronic Unilateral Vocal Fold Paralysis: A Comparative Study of Interventional Approaches
Mónica Teixeira1, Isabel García-López1, Javier Gavilán1
1ENT Department, Hospital Universitario La Paz, Madrid, Spain.
Objectives:
Managing chronic unilateral vocal fold paralysis (UVFP) typically involves a combination of voice rehabilitation and surgical interventions, such as injection laryngoplasty (IL), laryngeal framework surgery, and laryngeal reinnervation. Assessing treatment impact on voice quality is crucial to determine the effectiveness and guide further interventions. This study aimed to assess objective and subjective vocal outcomes associated with various interventional approaches in patients with chronic UVFP.
Methods:
This retrospective study included 90 patients with UVFP treated at Hospital Universitario La Paz between 2010 and 2024. Patients who experienced recovery of vocal fold mobility or had less than 1 year of follow-up after the onset of paralysis were excluded. Patients were grouped based on the therapeutic approach: group 1 (isolated voice therapy [VT]), n = 26; group 2A (IL), n = 16; group 2B (IL followed by medialization thyroplasty [MT]), n = 12; group 3 (MT), n = 36. Voice quality was evaluated at baseline and postintervention: at the end of VT; 3 months after IL; and 1 year after MT. Vocal parameters measured included the Voice Handicap Index-10 (VHI-10), GRBAS (grade, roughness, breathiness, asthenia, strain) scale, maximum phonation time (MPT), and maximal intensity.
Results:
Significant improvements were observed across all groups in VHI-10 scores, overall severity of dysphonia, and MPT postintervention. The MT group demonstrated the greatest degree of improvement in the overall severity of dysphonia and MPT. However, final vocal outcomes were comparable across all groups, with no statistically significant differences in VHI-10 (P = 0.157), severity of dysphonia (P = 0.258), MPT (P = 0.109), or maximal intensity (P = 0.853).
Conclusion:
While MT resulted in the greatest improvement in overall severity of dysphonia and MPT, all treatment modalities effectively improved voice quality. Ultimately, these interventions achieved comparable final vocal outcomes, highlighting the importance of individualized treatment strategies for patients with UVFP.
Related Concept Videos
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Larynx
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids,...
Cardiopulmonary Resuscitation II: ACLS Airway Management
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...

