Pediatric Unilateral Vocal Fold Paralysis

Abstract

Purpose: The aim of this case study was to provide a review of a pediatric patient diagnosed with unilateral vocal fold paralysis. Method: The case history, voice samples, laryngeal examinations, and diagnostic probes were reviewed in a 10-year-old girl with the chief complaint of persistent dysphonia, characterized by use of both a breathy and a typical voice. Perceptual ratings were completed using both Consensus Auditory-Perceptual Evaluation of Voice and Grade, Roughness, Breathiness, Asthenia, and Strain scales. Cepstral peak prominence was determined and compared for the same file segment using both Praat and Analysis of Dysphonia in Speech and Voice analysis programs. Treatment probes during the initial preoperative visit are described. Results: The patient was able to compensate for short phonation tasks, but longer conversations were judged to have increased dysphonia and increased vocal fatigue. Because noted compensation was unable to be stabilized or sustained, both a reinnervation of the ansa cervicalis to the recurrent laryngeal nerve and voice therapy techniques were recommended as part of the multidisciplinary team plan. Conclusion: Pediatric patients with unilateral vocal fold paralysis may present with complex phonatory behaviors. This case study paired with supplemental acoustic and videostroboscopy files provides an opportunity to practice both an auditory-perceptual and acoustic assessment and to rate a laryngeal examination. Supplemental Material: https://doi.org/10.23641/asha.24163926