The Role of Laryngology Evaluation in Parkinson Dysphonia Therapy: Process Evaluation and Outcomes

To describe the clinical evaluation process for patients with Parkinson disease (PD)-related dysphonia at an academic voice center, including potential delays in voice therapy initiation, the incidence of lesions at the time of screening laryngoscopy, and the frequency of procedural voice interventions.

Retrospective single-institution chart review of patients (n = 113) with PD-related dysphonia seen in consultation by a fellowship-trained laryngologist and speech language pathologist (SLP) between 2014 and 2024 who underwent either SPEAK OUT!® or Lee Silverman Voice Treatment®. Sociodemographic information, referral/clinical encounter dates, medical history, laryngoscopy findings, and details regarding procedural interventions were collected.

Thirty-three patients satisfied inclusion criteria, including those who underwent appropriate laryngologist clearance prior to voice therapy (n = 29) and those who saw a laryngologist following treatment initiation in delayed fashion (n = 4). Time from SLP intake to therapy initiation occurred approximately 2 months sooner when patients did not see a laryngologist prior to treatment (mean 46 days versus 117 days, P < 0.05.) Screening laryngoscopy findings and voice-directed interventions ultimately performed did not significantly differ between cohorts.

Requiring laryngology consultation for screening laryngoscopy prior to PD-directed voice therapy can delay care without affecting the procedural interventions ultimately performed. While all patients with PD-related dysphonia should undergo laryngoscopy at some time during treatment, these patients may benefit from timelier therapy if preceding medical clearance from laryngology is not required. Regardless of the timing of laryngologist consultation, select patients with PD may benefit from voice-directed interventions, and this warrants further study.