Author(s)
Jose Immanuel Ilagan, BS
Nathan R. Barefoot BS
Rupali N. Shah, MD
Robert A. Buckmire, MD
Affiliation(s)
University of North Carolina- Chapel Hill
Abstract:
Background: Glottic insufficiency commonly results from vocal fold paralysis, paresis, or atrophy. Type 1 thyroplasty has long been considered the gold standard for surgical rehabilitation of this condition. Following surgery, additional voice therapy is intermittently recommended to further optimize voice outcomes. However, its specific impact on voice outcomes after surgery poorly defined. Aims: Evaluate the impact of postoperative voice therapy on patient-reported outcome measures (“PROMs”): Voice Related Quality of Life and Glottal Function Index) and perceptual (Grade Roughness, Breathiness, Asthenia, Strain, “GRBAS”) voice outcomes following Type 1 thyroplasty, and, determine whether outcomes differ by demographic variables, timing or number of voice therapy sessions.
Methods: A retrospective chart review identified patients undergoing 1 thyroplasty and subsequent voice therapy between 2014 and June 2025. Demographics, diagnoses, surgical, and therapy variables were collected from patient charts. Available pre-operative, post-operative and post-therapy PROMs and perceptual ratings were collected. Changes in scores were analyzed using two-tailed T-tests.
Results: 76 patients met the criteria for inclusion. PROMs and GRBAS improved significantly following thyroplasty (both: p < 0.0001). No significant PROM improvement was observed following postoperative voice therapy. GRBAS demonstrated additional significant improvement following postsurgical voice therapy for the entire cohort, (p < 0.0001) and for the paresis diagnostic subgroup, but not for paralysis subgroup. No significant differences were detected across demographic or clinical subgroups for PROM nor GRBAS outcomes.
Conclusion: While PROM scores did not change significantly following postoperative voice therapy, GRBAS did, suggesting additional perceptual benefit to thyroplasty voice outcomes following post-operative behavioral voice therapy.