Effects of Voice Therapy as Objectively Evaluated by Digitized Laryngeal Stroboscopic Imaging

Abstract

Objective measurements derived from digitized laryngeal stroboscopic images were used to demonstrate changes in vocal fold vibration and in the size of benign lesions after 3 months of voice therapy. Forty chronically dysphonic patients were studied. By means of a rigid stroboscope, pretreatment and posttreatment recordings were made of the vocal folds at rest and under stroboscopic light during phonation. From each recording, images of the positions at rest and during vibration at maximal opening and at maximal closure were digitized. The surface areas of any lesions and of the glottal gap were independently measured in the digitized images by 2 experienced laryngologists. Referential distances were determined in order to compensate for discrepancies in magnification in the various recordings. After 3 months of voice therapy, significant improvement in lesion size and degree of maximal closure during vibration could be demonstrated in about 50% of the patients. The degree of maximal opening did not prove to be a significant parameter.

The Effectiveness of Voice Therapy for Teachers with Dysphonia

“…the percentage of patients with vocal nodules decreased by 11% in the voice-trained group. Some authors also reported effective voice therapy in patients suffering from minimal benign lesions of the larynx, which prevented phonosurgery [26,27] .…”

Boot Camp: A Novel Intensive Approach to Voice Therapy

“…Available evidence suggests that this traditional model of voice therapy delivery is not overwhelmingly successful. 3,5 Long-term outcome (greater than 1 year) suggests a high rate of partial recurrences of dysphonia in 51-68% of individuals. 6,7 Treatment success immediately after voice therapy is unclear with reports ranging from 41% to 96%.…”

“…6,7 Treatment success immediately after voice therapy is unclear with reports ranging from 41% to 96%. 1,3,5,6 Moreover, these reported treatment success rates of traditional voice therapy immediately posttreatment may be an overestimate because they do not include patient dropouts, which are reported to be large because of poor adherence to treatment regimes. High-dropout rates of 16-65% [8][9][10][11] coupled with reduced success rates of traditional voice therapy, suggest the need for development of new approaches of voice therapy delivery to improve treatment success.…”

Documentation of progress in voice therapy: perceptual, acoustic, and laryngostroboscopic findings pretherapy and posttherapy

“…These variabilities can be partly avoided by digital processing of the images, but such a procedure is restricted to high-quality recordings. 15 This study considers the effects of voice therapy in a group of chronically dysphonic patients. A multidimensional assessment protocol is used to provide information about the different effects on voice and vocal fold vibration.…”