Effect of Voice Therapy for Persistent Dysphonia Following Laryngeal Microsurgery

Abstract

Objectives: There are multidisciplinary and collaborative approaches for management of benign vocal fold lesions. Laryngeal microsurgery is one of the management procedures for treatment of dysphonia with medication and voice therapy. Laryngeal microsurgery, in particular, has been implemented when there is no vocal improvement after medication or voice therapy. However, voice problems often persist following surgery. The aim of this study was to investigate the effect of voice therapy in the treatment of postoperative functional dysphonia. Methods: Indirect and direct voice therapy consisting of laryngeal massage and semi-occluded vocal tract exercises (SOVTE) were performed on 14 female patients with dysphonia. Auditory-perceptual, acoustic analysis and the Korean version of Voice Handicap Index-10 (K-VHI-10) were compared before and after voice therapy. Results: In acoustic analysis, standard deviation of F0 (STD), Jitter, pitch perturbation quotient (PPQ), fundamental frequency variation (vF0), Shimmer, amplitude perturbation quotient (APQ), peak to peak amplitude variation (vAm), noise-to-harmonic ratio (NHR), degree of sub-harmonic (DSH) were significantly lower after voice therapy. Significantly lower levels of 'grade' , 'breathiness' , and 'strain' in GRBAS were revealed following voice therapy. In addition, K-VHI-10 was also significantly reduced after voice therapy. Conclusion: SOVTE and laryngeal massage were effective for patients with persists dysphonia by modifying or eliminating inappropriate vocal patterns that lead to voice dysfunction. Therefore, voice therapy following laryngeal surgery can be useful to recover vocal fold functions that cannot be solved by voice rest or vocal hygiene alone.

Voice therapy for pitch problems following thyroidectomy without laryngeal nerve injury

“…SOVTE는 성도의 앞이나 뒤의 일부를 폐쇄하여 발성하는 것으로 (Titze, 2006), 다양한 원인에서 비롯되는 병리적인 음 성장애의 음성치료와 직업적 음성사용자의 음성훈련에 효 과적인 방법으로 보고되고 있다 Kim et al, 2017Kim et al, , 2019 (Pozzali et al, 2021).…”

Effect of Voice Reinforcement Method for Treatment of Vocal Nodules: Preliminary Study

“…Kim et al 9,16) Chae et al 12) IV Generalization Voice focus Boone et al 5) *Self practice continues until the end of voice therapy (simple task: stage II, multiple tasks: stage III-IV)…”

Semi-Occluded Vocal Tract Exercises: Understanding the Prevalence and Purposes within the Collegiate Voice Instructor Population

“…32 Research teams began comparing SOVTEs to one another and categorizing them with respect to back pressure created, single or dual source exercises, intraoral pressures, and flow resistance. 19,24,25,[35][36][37][38][39][40] Interest in SOVTEs and aerodynamic principles was also prominent. [41][42][43][44] During this time several different studies addressed the significance of variability between the SOVTE and executor.…”

“…22,93 Several studies exist that have explored the differences in intra oral pressure created by different SOVTEs. 24,25,[35][36][37][38][39][40]48 Study participants mentioned using SOVTEs for purposes of offloading, reducing subglottic pressure, evenning of supra-, intra-, and subglottic pressure, and backing off vocal pressure. All of these uses are reinforced by published voice research.…”

“…Several of the initial codes that comprised this category are supported in voice science literature, such as warm-up, airflow, and respiratory function. 14,48,24,25,29,32,[35][36][37][38][39][40]43,[45][46][47][48][49]51,52 The remaining codes suggest a more performanceminded approach to the science of SOVTEs in partnership with mental health awareness and "vocal athlete" training. The data collected and analyzed in this portion of the study reveal a significant finding regarding the hybrid purposes of SOVTEs within collegiate voice studios.…”