Is voice therapy effective for the treatment of dysphonic patients with benign vocal fold lesions? 2018

Makoto Ogawa, and Hidenori Inohara
Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Japan. Electronic address: mogawa@ent.med.osaka-u.ac.jp.

OBJECTIVE To update our knowledge regarding the effectiveness of voice therapy for the treatment of vocal disturbance associated with benign vocal fold lesions, including vocal polyps, nodules and cysts, and for determining the utility of voice therapy in treating organic voice disorders, while highlighting problems for the future development of this clinical field. METHODS We conducted a review of the most recent literature on the therapeutic effects of voice therapy, vocal hygiene education or direct vocal training on vocal quality, the lesion appearance and discomfort felt by patients due to the clinical entity of benign vocal fold mass lesions. RESULTS Although voice therapy is principally indicated for the treatment of functional dysphonia without any organic abnormalities in the vocal folds, a number of clinicians have attempted to perform voice therapy even in dysphonic patients with benign mass lesions in the vocal folds. The two major possible reasons for the effectiveness of voice therapy on vocal disturbance associated with benign vocal fold lesions are hypothesized to be the regression of lesions and the correction of excessive/inappropriate muscle contraction of the phonatory organs. According to the current literature, a substantial proportion of vocal polyps certainly tend to shrink after voice therapy, but whether or not the regression results from voice therapy, vocal hygiene education or a natural cure is unclear at present due to the lack of controlled studies comparing two groups with and without interventions. Regarding vocal nodules, no studies have investigated the effectiveness of voice therapy using proper experimental methodology. Vocal cysts are difficult to cure by voice therapy without surgical excision according to previous studies. Evidences remains insufficient to support the use of voice therapy against benign vocal fold lesions. CONCLUSIONS Evidences at present is therefore still insufficient to support the use of voice therapy for the treatment of benign vocal fold lesions.

UI MeSH Term Description Entries
D007818 Laryngeal Diseases Pathological processes involving any part of the LARYNX which coordinates many functions such as voice production, breathing, swallowing, and coughing. Laryngeal Perichondritis,Larynx Diseases,Disease, Laryngeal,Disease, Larynx,Diseases, Laryngeal,Diseases, Larynx,Laryngeal Disease,Laryngeal Perichondritides,Larynx Disease,Perichondritides, Laryngeal,Perichondritis, Laryngeal
D011127 Polyps Discrete abnormal tissue masses that protrude into the lumen of the DIGESTIVE TRACT or the RESPIRATORY TRACT. Polyps can be spheroidal, hemispheroidal, or irregular mound-shaped structures attached to the MUCOUS MEMBRANE of the lumen wall either by a stalk, pedunculus, or by a broad base. Polyp
D003560 Cysts Any fluid-filled closed cavity or sac that is lined by an EPITHELIUM. Cysts can be of normal, abnormal, non-neoplastic, or neoplastic tissues. Cyst
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014827 Vocal Cords A pair of cone-shaped elastic mucous membrane projecting from the laryngeal wall and forming a narrow slit between them. Each contains a thickened free edge (vocal ligament) extending from the THYROID CARTILAGE to the ARYTENOID CARTILAGE, and a VOCAL MUSCLE that shortens or relaxes the vocal cord to control sound production. Vocal Fold,Vocal Folds,Vocal Ligament,Cord, Vocal,Cords, Vocal,Fold, Vocal,Folds, Vocal,Ligament, Vocal,Ligaments, Vocal,Vocal Cord,Vocal Ligaments
D014833 Voice Quality That component of SPEECH which gives the primary distinction to a given speaker's VOICE when pitch and loudness are excluded. It involves both phonatory and resonatory characteristics. Some of the descriptions of voice quality are harshness, breathiness and nasality. Qualities, Voice,Quality, Voice,Voice Qualities
D014834 Voice Training A variety of techniques used to help individuals utilize their voice for various purposes and with minimal use of muscle energy. Training, Voice,Trainings, Voice,Voice Trainings
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D055154 Dysphonia Difficulty and/or pain in PHONATION or speaking. Phonation Disorders,Spastic Dysphonia,Hyperkinetic Dysphonia,Neurologic Adducter Spastic Dysphonia,Organic Tremor Dysphonia,Spastic Dysphonia, Neurologic Adducter,Dysphonia, Hyperkinetic,Dysphonia, Organic Tremor,Dysphonia, Spastic,Phonation Disorder

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