In some patients with idiopathic vocal cord paralysis, spontaneous recovery remains possible — yet the clinical picture cannot wait. When aspiration or an uncompensated voice is present, earlier active management is warranted even while recovery is still anticipated.
Prognosis is transient or uncertain. Despite the expectation of spontaneous recovery of vocal fold mobility, the patient presents with aspiration and/or an uncompensated voice — findings that require prompt, targeted intervention to prevent complications and preserve quality of life during the recovery period.
Recovery of vocal fold mobility within 6–12 months from onset.
IL can be applied at any stage of UVFP. Early and active intervention with temporary injection materials is recommended to prevent lung complications and to ensure the quality of life of a patient with high vocal demands (strong recommendation, moderate-quality evidence).
Temporary or short-duration materials are used when spontaneous recovery of vocal fold mobility is expected (strong recommendation, moderate-quality evidence).
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.
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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