Objective: The purpose of this work was to study the efficacy of early voice therapy in the management of patients with unilateral vocal fold paralysis. Patients and Methods: Three groups of patients suffering from unilateral vocal fold paralysis were subjected to a protocol of voice evaluation including auditory-perceptual voice analysis, the Dysphonia Severity Index (DSI) and the 20-item Voice Problem Self-Assessment Scale (VPSS-20). Patients were also examined using video laryngostroboscopy. The early voice therapy group was enrolled in a voice therapy program for 16 sessions as soon as the patients were diagnosed; the second group of patients did not receive voice therapy during the course of their ailment. The late voice therapy group was enrolled in a voice therapy after a period of at least 6 months following the onset of vocal fold paralysis. All studied patients were reevaluated after a period of 2 months. Results: The early voice therapy group showed better outcomes regarding VPSS-20 scores, auditory-perceptual voice analysis as well as the DSI. Conclusion: Early onset of voice therapy may enhance the reduction in glottal gap and improvement of voice quality by hindering the development of faulty hyperfunctional compensatory behaviors; early voice therapy may therefore enhance the patient's quality of life.

Objective: To determine whether closed subcutaneous drainage systems were efficacious in reducing the rate of wound breakdown of Pfannenstiel incision after cesarean section (CS) in obese females. Design: Prospective controlled clinical trial. Participants: 118 obese pregnant females with a body mass index >32 undergoing CS were divided into two groups: group I (n = 78) with closed subcutaneous drainage system and group II (n = 40) without drainage system. Incision closure technique was standardized. Prophylactic antibiotics were given routinely to both groups. Outcome Measures: Primary outcomes were the incidence of wound breakdown in both groups together with rate of hematoma formation and occurrence of fever. Secondary outcomes were amount of fluid drained, need for redressing. Results: Wound breakdown occurred in 9 cases in group I (11.5%), while it happened in 5 cases in group II (12.5%) (p > 0.05). Relative risk was 0.92 (95% CI 0.26–3.75). Hematoma formation was observed in only 1 case in the nondrainage group (group II). Fever was observed in 18 cases in group I (23.1%) in the first 24 h postoperative while in group II, 13 cases developed fever (32.5%) (p > 0.05). The need for redressing within the first 24 h was only in 2.5% of cases in group I while it was 17.9% in group II (p < 0.05). Conclusion: We found no significant benefit in using a subcutaneous drain as a prophylactic measure against wound breakdown in obese pregnant females undergoing CS as long as they received a prophylactic antibiotic.

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