What non-surgical therapies help dysphagia with vocal cord paralysis?

The short version: no non-surgical therapy has been shown to restore vocal cord movement or fix dysphagia from a paralyzed cord after thyroidectomy. The evidence for neuromuscular electrical stimulation (NMES) is thin and comes from the wrong patients.

The evidence you were given does not answer your question. Most of the 27 records are about causes of vocal cord paralysis, not treatments. The one study that tested NMES on laryngeal muscles [2] treated only two women with suspected superior laryngeal nerve weakness, not recurrent laryngeal nerve injury from thyroid surgery. Both improved on voice measures after 8 to 17 sessions of NMES combined with voice therapy, but neither had the same injury you do. A 2017 review of unilateral recurrent laryngeal nerve injury after thyroid surgery [1] lists surgical options like injection laryngoplasty and reinnervation as the main treatments. It does not name a non-surgical therapy that restores nerve function or reliably improves swallowing.

The mechanism matters here. The recurrent laryngeal nerve controls the vocal cord's ability to close the airway during swallowing. When that nerve is cut, stretched, or trapped in scar tissue, no amount of electrical stimulation to the surface muscles will reconnect it. NMES can strengthen muscles that still have a working nerve supply, but it cannot replace a severed signal. The two patients in the NMES study [2] had nerve weakness, not paralysis, and the stimulation was applied to the cricothyroid muscle, which is controlled by a different nerve (the superior laryngeal). That study does not apply to your situation.

What is left is speech therapy for compensatory strategies and dietary changes to reduce aspiration risk. These do not fix the paralysis. They help you work around it. The 2017 review [1] confirms that the standard of care for persistent unilateral paralysis after thyroid surgery is surgical: injection laryngoplasty, medialization thyroplasty, or laryngeal reinnervation. Those are the interventions with evidence behind them.

My call: no non-surgical therapy has evidence to support it for dysphagia from post-thyroidectomy vocal cord paralysis. The only proven path is surgical correction by a specialist who treats recurrent laryngeal nerve injuries. Confidence: high.