Effects of speech therapy with or without transcutaneous electrical stimulation on patients with vocal cord paralysis after thoracic surgery.

BACKGROUND

Although thoracic surgical procedures are recognized as risk factors for unilateral vocal fold paralysis (UVFP), there is limited evidence regarding the optimal rehabilitation strategies for managing persistent cases. We evaluated the therapeutic efficacy of voice rehabilitation in patients with UVFP refractory to spontaneous recovery 3 months after thoracic surgery and examined the potential added value of selective electrical stimulation (SES) in clinical management.

METHODS

We retrospectively reviewed patients who underwent lobectomy, radical resection of esophageal cancer, or mediastinal tumor resection between March 2021 and September 2024, including those who underwent speech therapy (Group A) and those who underwent speech therapy and SES (Group B). The results of dynamic laryngoscopy, as well as subjective and objective voice analyses, were compared between the two groups.

RESULTS

We reviewed 35 patients, 19 in Group A and 16 in Group B. Both intervention groups demonstrated significant improvements (P<0.05) across all measured parameters, except for fundamental frequency (F0). Comparative analysis revealed that Group B exhibited superior glottic closure on the paralyzed side compared to Group A (P=0.04).

CONCLUSIONS

Structured speech therapy effectively addresses post-thoracic surgery UVFP, and our findings suggest that SES may augment therapeutic outcomes through enhanced glottic mobility. Further multicenter randomized trials are warranted to establish standardized treatment protocols.