The efficacy of voice therapy in vocal cord nodules

Abstract

Objectives: This study aims to investigate the efficacy of voice therapy in the treatment of vocal cord nodules with subjective and objective measurements. Patients and Methods: The study included 20 female patients with vocal cord nodules. The patients were divided into two groups randomly as study and control groups. Ten patients in the study group (mean age 30.4±8.1 years; range, 21 to 47 years) received voice therapy and anti-reflux treatment. Ten patients in the control group (mean age 32.1±10.5 years; range, 18 to 49 years) received anti-reflux treatment and vocal hygiene education. Voice Handicap Index-10 (VHI-10) questionnaire was completed, the maximum phonation time (MPT) and s/z ratio were measured, acoustic and aerodynamic analyses were performed on voice recordings before and after the treatments for both groups. Pre-and post-treatment videolaryngostroboscopic examinations were performed and the results were compared. Results: Maximum phonation time increased in the study group (p=0.042) but did not change in the control group. There was no difference in either group in terms of VHI-10, s/z ratio, average fundamental frequency, mean sound pressure level or air flow rate. In the study group, one vocal cord nodule disappeared, five vocal cord nodules decreased in size, and four remained the same. In the control group, four vocal cord nodules remained the same and six decreased in size. Conclusion: The majority of the vocal cord nodules did not disappear with voice therapy while they decreased in size. We observed an increment only in the MPT.

Paediatric vocal fold nodules: management strategies to restore normal phonation—Speech-Language Pathologists perspective: A cross-sectional survey

“…9 However, voice therapy is a valid option 10 and results in improvement in perceived quality of voice 11 with failure cases requiring surgical intervention. 4 With hard glottal attack seen quite frequently with bilateral VFNs, 12 13 Vocal hygiene and education programme is essentially required as it is a major part of the management plan of VFNs. 14 Hence, in the current study, 80% SLPs agreed to this.…”

“…Almost half of the sample, 52.3% agreed that combination of surgery and voice therapy is the best treatment and voice therapy can also reduce the chances of surgical intervention. 4 A few SLPs agreed on giving no treatment for VFNs in children because children were not trained regarding how to use their voices safely. However, in reality this can only be done for children in whom nodules start regressing while the children are progressing into adolescence.…”

“…Vocal hygiene as well as voice therapy are the essentially required conservative measures; however, in very few cases surgery is mandated. 4 Therapy techniques include direct voice therapy to modify vocal attitudes for a healthy voice, while indirect voice therapies modify the cognitive, psychological, behavioural and physical environment, including the patient's education, good vocal hygiene techniques and counselling. With low or no-evidence strategies like boone's technique 5 of voice therapy being used in paediatrics, research is required 6 to develop techniques, including tailored, evidence-based treatment strategies.…”