This protocol applies to patients with idiopathic vocal cord paralysis in whom spontaneous recovery of vocal fold mobility remains possible — prognosis is transient or unknown, the voice is currently compensated, and aspiration is absent.
Recovery of vocal fold mobility within 6–12 months from onset.
Because spontaneous recovery remains possible, this protocol favours less invasive management during the waiting period — options may include voice-based therapy or a time-limited procedural approach, with selection depending on the patient's vocal demands and clinical context.
DOI: 10.1177/0194599817751030
For patients with a compensated voice and no aspiration, less invasive treatment, such as a wait-and-see approach, IL with temporary material, and voice therapy are applicable, depending on the patient's need or profession, but for patients with a high vocal demand, uncompensated voice, or aspiration/dysphagia, SMPs are preferred.
Temporary IL is preferred for cases of UVFP with no apparent cause (i.e., where there is a possibility of recovery of neural function).
In patients with mild symptoms and adequate airway protection, several options may be considered, including a wait-and-see approach, voice therapy, and medialization procedures (see KQ 5–15).
Voice therapy may be used to improve voice outcomes for patients with mild symptoms or if surgical medialization procedures are not available (strong recommendation, low-quality evidence).
Temporary or short-duration materials are used when spontaneous recovery of vocal fold mobility is expected (strong recommendation, moderate-quality evidence).
Spontaneous recovery of vocal fold mobility can occur within 6–12 months from the onset of UVFP (strong recommendation, moderate-quality evidence).
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