Physiotherapy Management of Vocal Cord Paralysis in a Nigerian Hospital: A Case Report

Abstract

Background: Vocal cord paralysis is disabling and can lead to morbidities such as dysphagia, dysphonia and aspiration. It can also lead to loss of quality of lives and productivity in sufferers. An appropriate understanding of etiologies, signs and symptoms, diagnosis and management are essential in offering patients appropriate treatments. This article discussed a case report of the physiotherapy assessment and management of a patient with vocal cord paralysis. Case Presentation and Treatment Outcome: A case report of the assessment and management of a 38-year old male patient with vocal cord paralysis. Patient was referred from Ear, Nose and Throat (ENT) department to the physiotherapy department after an emergency tracheostomy done 2 months prior to referral. He was given appropriate physiotherapy intervention after a thorough assessment. Voice Handicap Index Score (VHIS) was used to assess voice projection of the patient. The Numerical Pain Rating Scale (NPRS) was used to assess the level of pain while tape measure was used to measure chest excursion. The CARE: CAse REport guideline for case reports was followed. All ethical procedures were followed as well. Treatment outcome revealed full AROM of the neck, increased chest excursion (from 2cm to 3.5cm), no hoarseness, no choking during deglutition and a Voice Handicap Index score of 25 after 10 treatment sessions. Pain level on Numerical Pain Rating Scale (NPRS) was reduced from 8/10 to 2/10. Conclusion: Physiotherapy is effective in the management of vocal cord paralysis. Early referral to Physiotherapy is advised for good prognosis. Adequate teamwork and proper communication pathways should be encouraged in hospitals for good treatment outcome.