Treatment Effects of Combined Transoral Injection Laryngoplasty with Short Voice Therapy in Patients with Unilateral Vocal Fold Immobility: A Pilot Study.

The sample size was very small (17 patients), and the study was underpowered for several parameters, including mean speaking fundamental frequency and singing range. The retrospective design introduced selection bias, with 229 of 246 eligible patients excluded due to missing data or incomplete follow-up. Voice therapy was not standardized; it was tailored case-by-case, and the specific contribution of short voice therapy versus injection laryngoplasty cannot be separated. There was no control group or comparison to injection alone or therapy alone. Acoustic analysis did not use signal typing, which may affect the reliability of jitter and Dysphonia Severity Index measurements. Minimal clinically important differences for voice range profile measures have not been established, making it difficult to judge the clinical significance of the observed changes.

The authors declared no conflicts of interest. The study was supported by the Division of Phoniatrics and Speech Pathology and the Clinic for Otorhinolaryngology, Head and Neck Surgery at University Hospital Zurich. The funder had no role in the study design, data collection, analysis, or reporting.

Do not attribute the observed improvements to short voice therapy alone or to injection laryngoplasty alone. Both treatments were delivered together, and the paper explicitly states that the contribution of any single component cannot be separated.