Guidelines for the Management of Unilateral Vocal Fold Paralysis From the Korean Society of Laryngology, Phoniatrics and Logopedics
Clinical and Experimental Otorhinolaryngology
Korean Society of Laryngology, Phoniatrics and Logopedics Guideline Task Force, Ryu, C. H., et al. (2020).
Clinical and Experimental Otorhinolaryngology, 13(4), 340-360.
This guideline from the Korean Society of Laryngology, Phoniatrics, and Logopedics provides recommendations regarding the management of unilateral vocal fold paralysis in individuals.
Korean Society of Laryngology, Phoniatrics and Logopedics
<div>In individuals with unilateral vocal fold paralysis who have mild symptoms or are not surgical candidates, voice therapy can be used to improve outcomes (Strong Recommendation, Low-Quality Evidence). Patients who are able to undergo surgery for UVFP can receive voice therapy before and/or after surgical intervention to improve postoperative phonation (Strong Recommendation, Low-Quality Evidence).</div>
<div>The following is recommended when evaluating individuals with unilateral vocal fold paralysis:</div>
<div>
<ul>
<li>Laryngoscopy is an essential diagnostic tool for confirming immobility of the vocal fold (Strong Recommendation, High-Quality Evidence; p. 4).</li>
<li>Stroboscopy is helpful for evaluating glottal closure, the mucosal wave, and vocal fold asymmetry (Weak Recommendation, Low-Quality Evidence; p.4).</li>
</ul>
</div>
<div>For individuals with unilateral vocal fold paralysis, voice assessment should be conducted before and after treatment. Assessment results should guide the development of treatment plans and measure outcomes (Strong Recommendation, High-Quality Evidence).</div>
<div>For individuals with unilateral vocal fold paralysis, assessment tools should be selected based on the ability of the individual to participate effectively and on the examiner's familiarity with the tool (Strong Recommendation, Low-Quality Evidence).</div>
<ul>
<li>Perceptional observation to examine vocal quality can use the Grade, Roughness, Breathiness, Asthenic, and Strained (GRBAS) scale.</li>
<li>Acoustic parameters such as jitter, shimmer, noise-to-harmonic ratio can provide objective assessment of vocal quality.</li>
<li>Aerodynamic parameters such as maximum phonation time and mean airflow rate can help assess glottal insufficiency.</li>
<li>Self-rating questionnaires such as the voice handicap index can measure the individual's perception of their own vocal status.</li>
</ul>
