Objective: Recent advancements in otolaryngology have led to a more nuanced understanding of vocal fold impairment, distinguishing vocal fold paresis from vocal fold paralysis. Treatments for vocal fold paresis include voice therapy and surgical interventions, such as injection augmentation or laryngeal surgery. Currently, little is known about the patients’ profiles of those who select voice therapy as their treatment option versus those who select to undergo surgery. The purpose of this study was to identify metrics that may guide treatment decisions for vocal fold paresis.

Methods/Design: A chart review of 150 adult patients with the clinical diagnosis of “vocal fold paresis” was completed. Patients' charts were examined and categorized according to gender, age at diagnosis, previous treatment history, and the types of treatments administered. Assessments of voice severity were made by using the self-assessment scores from the Voice Handicap Index-10 (VHI-10). The subjects were grouped according to those with no treatment and those who have received either voice therapy or surgery. Comparisons of the groups were made at the initial consultation according to the severity of the voice disorder, age, and gender.

Results: There were 76 females and 74 males included in this study. The average age at diagnosis for females was 60.7 years old and for males it was 63.9 years old. Forty-eight percent (n=72) of the participants fell in the no treatment group and had a mean VHI-10 of 10.1. Eighteen percent (n=27) of patients received voice therapy only and had a mean VHI-10 score of 15.6. Of those who went to surgery, twenty-three percent (n= 34) of the patients received surgery only and had a mean VHI-10 score of 21.1. The remaining subjects (n=17) were treated with both surgery and voice therapy with a mean VHI-10 of 21.8. Of these patients, the group that received surgery and continued with voice therapy had a mean VHI-10 score of 15 while the group that received voice therapy prior to surgery had a mean VHI-10 score of 24.5.

Conclusions: These results suggest that the severity of the voice at the time of diagnosis is a factor in determining the choice of no treatment versus treatment. As we continue to distinguish vocal paresis from vocal paralysis, there is still a challenge of defining standardized metrics for directing treatments for a large number of patients. This data provides a basis for guiding treatment decisions for vocal fold paresis.