Abstract
PurposeElectrical stimulation-supported therapy is an often used modality. However, it still belongs to experimental methods in the human larynx. Data are lacking with which to evaluate the real effect in recurrent laryngeal nerve injury. The aim of this study was to investigate whether transcutaneous electrical stimulation added to voice therapy has a beneficial effect compared to voice therapy alone on vocal fold movement recovery in the case of an injured macroscopically intact recurrent laryngeal nerve.MethodsAdults with unilateral vocal fold paralysis after thyroidectomy, in which the recurrent laryngeal nerve was left macroscopically intact, were included in this case–control study performed in tertiary referral hospital between September 2006 and June 2018. Among 175 eligible participants, 158 were included. Compliance with 6 months follow-up was 94.3%. Interventions: medicament therapy and voice therapy (group 1) vs. medicament therapy and voice therapy and transcutaneous electrical stimulation (group 2). Main outcome: vocal fold movement.ResultsA total of 149 patients were included in the analysis (group 1, 89 patients; group 2, 60 patients). The groups were homogenous. In groups 1 and 2, 64% and 60% of vocal folds, respectively, were improved after 6 months (P = 0.617). No difference was found between patients who improved and patients who did not improve.ConclusionsAdding transcutaneous electrical stimulation to voice therapy provided no beneficial effect on the recovery of vocal fold movement. Therefore, its indications should be re-evaluated; it is questionable whether stimulation should be routinely recommended.
Highlights
Recurrent laryngeal nerve (RLN) lesions cause vocal fold paralysis, and the symptoms are dependent on the position in which the vocal fold remains [1]
Voice therapy is currently recommended in the case of postoperative vocal fold paralysis [13, 14]
Voice exercise was compared to electrical stimulation–supported voice exercises in 88 patients with unilateral vocal fold paralysis, and added electrical stimulation was superior in terms of vocal fold vibration irregularity after 3 months
Summary
Recurrent laryngeal nerve (RLN) lesions cause vocal fold paralysis, and the symptoms are dependent on the position in which the vocal fold remains [1]. The lesions can be almost asymptomatic to unprofessional hearing in as many as 30% of patients or can cause incomplete glottic closure, which can lead to dysphonia, dysphagia, or life threatening aspiration in some cases [2]. These symptoms can significantly deteriorate the patients quality of life. RLN lesions are most often iatrogenic, caused by operations on the thyroid or parathyroid gland. RLN injury is one of its most feared complications, with rates of
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