The possibilities of medical and pedagogical rehabilitation of patients with unilateral paresis of the larynx
Stepanova Yu.E., Gotovyakhina Т.V., Makhotkina N.N., Mokhotayeva M.V.

St. Petersburg Scientific Research Institute of Ear, Nose, Throat and Speech

The main cause of the larynx paresis is the trauma of the recurrent laryngeal nerve during operations on the thyroid gland. This article presents the experience of specialists of the phoniatric department of St. Petersburg Research Institute of Ear, Nose, Throat and Speech in the treatment of patients with unilateral postoperative paresis of the larynx. 
The aim of the study was to evaluate the effectiveness of the complex drug treatment, physiotherapy and early phonopedic correction in patients with unilateral paresis of the larynx.
Patients and Methods: 74 patients with unilateral paresis of the larynx after operations on the thyroid gland participated in the study. The terms of application to the phoniatrist varied from 3 days to 1 year after the operation. The scheme of complex treatment included medication, physiotherapy (neuromuscular electrophonopedic laryngeal stimulation) and phonopedic correction. The results of the rehabilitation were assessed according to video endoscopy of the larynx and acoustic computer analysis before the treatment, during the treatment and after the completion of the course of therapy.
Results of the study: during the treatment, recovery of the laryngeal mobility was achieved in 12 (16.2%) patients within the period of 1 to 4 months after the operation. Normalization of the voice function due to the development of compensatory mechanisms of phonation with preservation of the laryngeal paresis was observed in 61 (82.4%) of the patients. In 1 (1.4%) patient the effect of treatment was unsatisfactory because of signs of hypotrophy of the larynx muscles on the paresis side due to the resection of the recurrent laryngeal nerve during the operation.
Conclusion: for a full rehabilitation of patients with unilateral paresis of the larynx, an early start of complex treatment consisting of drug therapy, physiotherapy and phonopedic correction is necessary. Phonopedic correction of voice disorders in cooperation with endocrine surgeons and otorhinolaryngologists, started at the earliest possible time of laryngeal paresis, will improve the efficiency of rehabilitation of patients.

Key words: larynx paresis, video endoscopic larynx, computerized acoustic analysis, neuromuscular electrophonopedic stimulation, phonopedy, physiotherapy.
For citation: Stepanova Yu.E., Gotovyakhina Т.V., Makhotkina N.N., Mokhotayeva M.V. The possibilities of medical and pedagogical rehabilitation of patients with unilateral paresis of the larynx // RMJ. 2017. № 23. P. 1712–1716.