Rehabilitation Department, Daping Hospital, Army Medical University, People's Liberation Army (PLA), Chongqing, China.
Rehabilitation Department, Xingcheng Sanatorium of PLA Strategic Support Force, Xingcheng, China.
Phys Ther. 2020 Dec 7;100(12):2198-2204. doi: 10.1093/ptj/pzaa167.
Unilateral vocal fold paralysis (UVFP) can be caused by iatrogenic injury or tumor-induced damage to the recurrent laryngeal nerve. Studies of comprehensive rehabilitation therapies for patients suffering from severe UVFP are limited. The purpose of this case report is to describe an improvement in complete aphonia after comprehensive rehabilitation therapies in a patient with severe UVFP due to a lung tumor.
An 81-year-old woman with a history of bronchial adenoma had complete aphonia due to compression of the left recurrent laryngeal nerve by the tumor. Dynamic fibrolaryngoscope revealed paralysis of the left vocal fold. The patient was treated with interferential current therapy, vocal training, and kinesiology taping. Indicators of voice recovery were scored according to the grade, roughness, breathiness, asthenia, strain scale, and the voice handicap index.
After 10 days of comprehensive rehabilitation treatment, the patient recovered from complete aphonia to normal communication. The hoarseness and breathiness of patient were significantly improved. In addition, the grade, roughness, breathiness, asthenia, strain, and the voice handicap index scores changed from severe to mild or absent.
This case provided a novel comprehensive treatment for a patient with UVFP, which was safe, cost-effective, and easy to implement in clinic.
医源性损伤或肿瘤引起的喉返神经损伤可导致单侧声带麻痹（UVFP）。对于严重 UVFP 患者的综合康复治疗研究有限。本病例报告的目的是描述 1 例因肺部肿瘤导致严重 UVFP 患者在接受全面康复治疗后完全失音的改善情况。
1 例 81 岁女性，有支气管腺瘤病史，因肿瘤压迫左侧喉返神经而完全失音。动态纤维喉镜显示左侧声带麻痹。患者接受干扰电疗、发声训练和运动贴扎治疗。根据嗓音障碍指数（GRBAS）量表、嗓音障碍严重程度分级（VHI）及声学分析对嗓音恢复的指标进行评分。
经过 10 天的综合康复治疗，患者从完全失音恢复到正常交流。患者的嘶哑和气息声明显改善。此外，等级、粗糙、气息声、乏力、紧张度以及嗓音障碍指数评分从重度变为轻度或消失。
本病例为 UVFP 患者提供了一种新的综合治疗方法，该方法安全、经济有效，且易于在临床中实施。
