Non-phonatory Exercises in Patients with Unilateral Vocal Fold Paralysis Post-thyroidectomy

Fondazione Policlinico Universitario Agostino Gemelli IRCCS56 enrolled

Overview

Thyroidectomy is the most common iatrogenic cause of vocal fold paralysis. Patients complain of hoarseness caused by incomplete glottic closure and have effort to raise vocal intensity with consequent elevation of the larynx and/or involvement of supraglottic structures in phonation. These compensation mechanisms result in a shift of the fundamental frequency towards more serious tones or falsetto voice emissions. The first choice treatment is speech therapy which aims to obtain better glottic closure, preventing ankylosis of the crico-arytenoid joint. In order to promote better glottic closure without risking the onset or increase of dysfunctional compensation, the idea behind this project is to propose non-phonatory adduction exercises in the first post-operative week. The primary objective of the study is to compare patients who will perform non-phonatory exercises in parallel with medical therapy for one week and patients who will perform standard medical therapy only during the first week.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Unilateral Vocal Cord Paralysis

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * vocal fold paralysis after thyrodectomy * ability to sign an informed consent Exclusion Criteria: * Vocal fold paralysis with different etiology * Previous history of laryngeal, pulmonary or gastric surgery * History of vocal or laryngeal pathologies that have required therapy * Current or previous lung disorders * Hearing loss * Motor or neurological deficits * Presence of malignant diseases * Presence of speech or reading disorders

Outcomes

Primary Outcomes

Degree of glottic closure

A videostrobolaryngoscopy will be performed. The recorded videos will be viewed by expert clinicians and a numerical score will be assigned relating to the degree of glottic adduction on a 7-point scale.

Time frame: 3 months

Secondary Outcomes

Acoustic analysis (fundamental frequency)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the Fundamental Frequency (F0, Hz) will be analysed.

Time frame: 3 months

Acoustic analysis (NHR)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the noise/harmonics ratio (NHR) will be analysed.

Time frame: 3 months

Acoustic analysis (Jitter%)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the Jitter (%) will be analysed.

Time frame: 3 months

Acoustic analysis (Shimmer%)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the Shimmer ( %) will be analysed. f

Time frame: 3 months

Acoustic analysis (Flow)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the minimum frequency (Flow) will be analysed.

Time frame: 3 months

Acoustic analysis (Fhigh)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the maximum frequency (Fhigh) will be analysed.

Time frame: 3 months

Acoustic analysis (intensity)

Through the use of the "Praat" software, on the reading of the piece "The desert" and on a sustained /a/ the intensity (dB) will be analysed.

Time frame: 3 months

MPT

the Maximum Phonatory Time (MPT) will be evaluated on a sustained /a/ (minimum 3 seconds)

Time frame: 3 months

Non-phonatory Exercises in Patients with Unilateral Vocal Fold Paralysis Post-thyroidectomy

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes