Effectiveness of Laryngostroboscopy for Monitoring the Evolution of Functional Dysphonia after Rehabilitator Treatment

Abstract

The aim of this study is to evaluate the effectiveness of the laryngostroboscopy for monitoring the evolution of patients with functional dysphonia before and after the logopedic vocal treatment. We performed a prospective observational study of 65 dysphonic patients diagnosed of functional dysphonia, where we analyzed four stroboscopic parameters (glottal closure, vocal fold vibration, mucosal wave and phase symmetry) by a protocol based on systematic subjective evaluation of the stroboscopic images before and after the rehabilitator treatment; and the results were stratified according to the clinical course. All patients, before the treatment, had some abnormality in at least one of the four analyzed aspects. After the vocal treatment, we found improvement of the four parameters in different degrees, and we just found a statistically significant relationship between the evolution of the glottal closure and the clinical course. We believe that the laryngostroboscopy, systematized through a protocol, is a useful technique for the diagnosis of functional abnormalities in patients with functional dysphonia but it is not a very useful technique for evaluating the results after the rehabilitator treatment, as there is not a statistically significant relationship between clinical course and the change in the most stroboscopic parameters, so it shouldn't be the only technique used for these proposes.

Functional dysphonia: strategies to improve patient outcomes

“…Even though, VLS is a useful tool for voice evaluation, it should not be the sole method used for diagnostic purposes, since there is no relationship between the clinical course and changes in stroboscopic data. 24 Recent technical advances, such as high-speed cameras, are more sensitive and offer more detailed information about phonatory function. However, they are expensive and there are many methodological challenges to overcome (such as excessive data and time-consuming analysis) before proposing it as a clinical tool for the evaluation of patients with voice problems.…”

“…A visual examination of the larynx can be used as a direct feedback tool during vocal rehabilitation, regardless of the fact that stroboscopic findings do not always correspond with voice improvement. 24 It allows patients to realize what the mechanics of voice is and how the treatment affected the laryngeal configuration and activity. 115 …”

Effects of indirect vocal therapy via telehealth in speech-language therapy on self-assessment and vocal quality of physical education professionals

“…In the voice area, there are several therapeutic approaches, each one with its particularities regarding its proposals and intervention methods [7][8][9][10][11] . The different approaches can be divided into two large groups: direct and indirect voice therapy 8,12 , both of which are applied in voice training and treatment 13,14 .…”

Efeitos da terapia vocal indireta via telefonoaudiologia na autoavaliação e qualidade vocal de profissionais da educação física

“…Na área da voz, existem diversas abordagens terapêuticas, com propostas e métodos de intervenção com particularidades próprias [7][8][9][10][11] . As diferentes abordagens podem ser divididas em dois grandes grupos: a terapia vocal direta e a indireta 8,12 , sendo ambas aplicadas no treinamento e tratamento vocal 13,14 .…”