Change in Voice Quality with Voice Therapy, Injection Laryngoplasty, and Medialization Thyroplasty.

Introduction: In patients with unilateral vocal fold paralysis (UVFP), voice therapy (VT), injection laryngoplasty (IL), and medialization thyroplasty (MT) are reported to produce significant improvement in voice quality (VQ). However, their long-term outcomes have not been sufficiently evaluated. We assessed the improvement in VQ with VT, IL, and MT over 12 months. Materials and Methods: This prospective observational study involved 95 adult patients with UVFP, categorized into three groups: VT (n=55), IL (n=36), and MT (n=4). The VQ was assessed with voice handicap index (VHI), maximum phonation time (MPT), phonatory gap (PG), and breathy voice quality (BVQ) on Day 1, 15, 30, 90, 180, and 360. Results: In the VT group, the decrease in PG, VHI score, and BVQ score was significant from Day 15, 30, and 30, respectively, while MPT increased significantly from Day 15 (p<0.05). In the MT group, similar changes were observed; however, these changes were significant from Day 1 (p<0.05). In both the groups, the lowest PG, VHI score, and BVQ score, and the highest MPT were attained on Day 360. In the IL group, PG, VHI score, and BVQ score decreased significantly, and MPT values increased significantly at every visit (p<0.05). However, PG, VHI score, and BVQ score started increasing and MPT started decreasing from Day 90, 15, 90, and 180, respectively. Conclusion: All treatment modalities improved the VQ significantly, immediately with IL and MT, and gradually with VT. Moreover, the improvement was long-term with VT and MT, and of intermediate duration with IL.