Objective
Speech-Language Pathologists infrequently assess children with vocal fold paralysis. This study examines management of a large group of children who underwent laryngeal reinnervation to resolve voice and swallow complaints.
Methods/Design
This retrospective study reviewed speech and swallow therapy management for 100 pediatric patients with vocal fold paralysis who underwent laryngeal reinnervation.
Results
Children with vocal fold immobility were found to have increased attention to both voice and swallow skills prior to laryngeal reinnervation surgery with targeting of voice skills post-operatively. While therapy probes pre-innervation addressed tonal placement, breath management, posture, and ease of voice, attention was also paid to avoidance of strain and/or compensatory muscle tension. Due to a higher incidence of aspiration, preoperative assessment and therapy often targeted safety of swallow. The majority of initial patients were not recommended for continued voice therapy post-ANSA. There is now an increased number of patients who benefit from voice therapy to maximize outcomes. Objective measures confirmed improved voice and swallow function following reinnervation.
Conclusions
Management of pediatric dysphonia and dysphagia due to vocal fold immobility is not a common skill set for the Speech-language pathologist. Just as surgical management for paralysis has changed, so has the toolbox for the SLP. Our review of 100 cases revealed changes in treatment probes as well as expansion of therapy goals due to research on specific exercises to target aerodynamics and awareness of complexity of management across voice and swallow for children with vocal fold paralysis.