Author/Editor		Večerina-Volić, Santa; Prstačić, Ratko; Živković, Tamara; Ibrahimpašić, Tihana; Starčević, Martina
Title		Phonatory function and voice therapy of unilateral recurrent nerve paralysis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. Suppl 3
Publication year		2004
Volume		str. 217-20
Language		eng
Abstract		The first step in the management of patients with a diagnosis of unilateral recurrent nerve paralysis (RNP) is to determine the exact etiologic mechanism, because it can be an indicator of a serious condition (e. g. laryngeal carcinoma). 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 an adequate rehabilitation process. The phonatory function is investigated using digital endoscopic technology, acoustic analysis and aerodynamic tests, all of which include manual laryngeal pressure medialisation to evaluate its effect on vocal fold adduction and phonation. Voice analysis should include subjective and objective evaluation; subjective through a questionnaire filled out by every member of the phoniatric team treating the patient and objective using the PRAAT computer programme. As already reported, there were 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 the majority of patients had degeneration, with a glottic sulcus on the vocal fold that was previously considered healthy, and some developed compensatory adduction of the ventricular fold that additionally deteriorated the voice. In such cases, surgical medialisation is suggested, which results in satisfactory glottic adduction and consequentially adequate laryngeal function.
Descriptors		VOCAL CORD PARALYSIS VOICE QUALITY VOICE TRAINING