Patient Selection Trends in Age, Gender, and Voice Severity in Patients with Vocal Fold Paresis.

Objectives

Advances in otolaryngology have led to improved differentiation between vocal fold paresis and paralysis. Treatments for vocal fold paresis include voice therapy and surgical interventions, such as injection augmentation or laryngeal surgery. Limited data exist regarding patient profiles associated with trends in initial treatment selection of voice therapy versus surgical treatment. The purpose of this study was to describe trends in treatment selection for patients with vocal fold paresis.

Methods

A retrospective chart review was conducted of 150 adult patients with a clinical diagnosis of "vocal fold paresis." Data collected included age at diagnosis, gender, voice severity assessed using the Voice Handicap Index-10 (VHI-10), and treatment modality options (no treatment, voice therapy, or vocal fold augmentation). Common comorbidities were also collected. Comparisons were made at the initial consultation according to VHI-10 score, age, and gender.

Results

This study included 76 females and 74 males. For severity, we found that for every 1 unit increase in VHI-10 score, the odds of receiving no treatment decreased by 8% (sig @ 0.000001) and the odds of receiving vocal fold injection (VFI) increased by 7% (sig @ 0.0004). For every 1 unit of increase in age, the odds of receiving no treatment decreased by 3% (sig @ 0.0082) and the odds of receiving VFI increased by 3% (sig @ 0.0446). Gender was not statistically significant when choosing between no treatment and treatment (P-value = 0.903). Patients who did not receive treatment were more likely to have no major comorbidities, whereas those who received voice therapy or VFI more commonly had at least one.

Conclusions

This study provides objective data for describing patient treatment selection following the diagnosis of vocal fold paresis. These results suggest that age and voice severity at the time of diagnosis are factors associated with initial patient treatment selection.