The impact of disordered vocal folds' mobility on laryngeal functions

The vocal fold paresis is most often caused by damaged nerves, a consequence of a trauma to the central or peripheral nervous system. Unilateral or bilateral paresis or paralysis of the recurrent laryngeal nerve are the most frequent causes of a partial or complete loss of flexibility of either one or both of the vocal cords, thus affecting vital functions such as breathing, swallowing and speech. In my master's thesis I have researched the effects of limited vocal cord flexibility on the functions of throat and the role speech therapy plays in the whole matter. In my thesis I have specified the structures present at the point of speech formation, the anatomy and innervation of the throat, aetiology and a clinical image of paresis of the superior and recurrent laryngeal nerves. I have also described the diagnostics and available treatment options, in other terms the rehabilitation of the dysfunctional flexibility of vocal cords, whilst mostly focusing on treatment involving speech therapy. The empirical part of my research consists of a survey conducted with the patients suffering from unilateral paresis or paralysis of the vocal cords, who were in the year 2013 initially examined at the Department of Otorhinolaryngology and Cervicofacial Surgery (Center for vocal disorders and speech impediment) as the result of the described disorder. Patients filled in a survey questionnaire, which comprised of a shortened translated version of the »Voice Handicap Index« questionnaire - » Voice Handicap Index -10« (VHI 10), along with questions regarding their experience with swallowing and breathing. I have then compared the acquired data with results obtained from a control group consisting of healthy volunteers of similar age. I have also gathered information by analysing medical documentation of the patients, who have granted me access to their medical records. The purpose of the research was establishing if the causes of vocal cord paresis are significantly different in Slovenia in comparison with other countries and also finding out a potential connection between treatment process and the clinical condition of the patients following a year long treatment. I was primarily interested in finding any variations of the level of sensory disability due to vocal disorders and issues with swallowing and breathing, after at least a year has passed since the issue first appeared, and comparing the patients who took part in speech therapy to those who have not. The research indicates the majority of patients' aetiology in regards to dysfunctional vocal cords remains unknown and is followed by the recurrent laryngeal nerve disorder resulting from thyroidectomy and presenting the cause for the appearance of this issue. I have found the patients' biggest handicaps were those related to vocal functions, followed by issues with swallowing and breathing. The research has shown that only 23 % of the patients taking part in the survey have experienced a functionality improvement without receiving any treatment. Due to an insufficient speech therapy implementation, I was unable to establish whether the patients taking part in the speech therapy treatment, experience a faster improvement of the symptoms compared to those not being treated at all. For patients participating in speech therapy, treatment was based on performing manual manipulation. I have also come to the conclusion, that the most common long-term vocal disorder with patients suffering from paresis or paralysis of the vocal cords, is vocal fatigue. The research also pointed out the issues patients suffering from unilateral vocal cord immobility have with swallowing and breathing aren't rare and along with the dysfunction of vocal cords, largely affect the quality of patients' lives and their work