Therapy
If vocal fold paresis is present, the therapy is initially dependent on the cause. The goal is always to bring the vocal folds as close as possible to each other again. If, for example, compression of the recurrent nerve by a tumor or aneurysm is the cause of vocal fold paresis, the therapy consists in removing these constricting processes.
Often vocal fold paresis recovers over time. If the nerve was injured during surgery or if there is an irreversible paralysis, further therapeutic measures must be initiated. Speech therapy plays a major role in this process, and almost every patient with vocal fold paresis takes advantage of it.
Special exercises are used to improve speech. If this is also not crowned with success, an invasive therapy can be useful. The affected side of the vocal fold can be injected with special substances to bring it closer to the center.
There are also surgical techniques in which a stamp (thyroplasty according to Isshiki) is used to push one side further towards the center or to pull it in this direction with sutures (arythenoid adduction). These methods are useful in unilateral vocal fold paresis. The rare bilateral paralysis of the vocal folds may require a tracheotomy in an emergency to avoid suffocation.
Speech therapy is an important pillar of treatment in most cases of vocal fold paresis. With the help of special exercises, under the professional guidance of the speech therapist, the patient can train his vocal folds to such an extent that a significant improvement of the voice is possible up to complete recovery. Speech therapy for vocal fold paresis is very promising, especially if the nerve has not been completely severed. The goals of speech therapy are to stimulate the muscles in the larynx and prevent atrophy, as well as to train the healthy side of the vocal folds beyond the normal level, so that it extends from the middle to the paralyzed side. In this way, normal speech can be generated by closing the glottis
