Kate A. Emerich

Unilateral recurrent laryngeal nerve paralysis:The importance of “preoperative” voice therapy

This preliminary retrospective study of 19 female patients and 22 male patients with unilateral recurrent nerve lesions demonstrated the promise of objective measurements in predicting the need for surgery, the efficacy of voice therapy in ameliorating vocal symptoms, and the effects of therapy in conjunction with surgery. Sixty-eight percent (68%) of the female patients and 64% of the male patients did not elect to have surgery. Outcome satisfaction of nonsurgical and surgical patients appeared to be similar. The data from this study support the importance of preoperative therapy for patients with unilateral vocal fold paralysis.

PHONOMICROSURGERY III: PRE- AND POSTOPERATIVE CARE

This article discusses the important aspects of pre- and postoperative care for phonomicrosurgical procedures. Making an accurate diagnosis is paramount to any surgical decision, which involves interdisciplinary evaluations by a laryngologist, voice pathologist, singing voice specialist, and other specialists. Patient selection and candidacy for phonomicrosurgery are discussed, including preoperative vocal rehabilitation, compliance, and pre- and postoperative timing issues. Postoperative voice rest issues are covered, and suggestions for postoperative voice rehabilitation are made. Risks of surgery and potential problems following phonomicrosurgery procedures are presented.