2020 Volume 61 Issue 3 Pages 237-244
To evaluate the effects of voice therapy for 35 patients with vocal fold nodules performed in our clinic, we measured voice handicap index (VHI) and maximum phonation time (MPT) before and after the therapy and analyzed the results. GRBAS scale was also used, and for acoustic aspects, jitter, shimmer, noise-to-harmonic ratio (NHR), and fundamental frequency (F0) were evaluated. We observed significant improvements in VHI, MPT, and shimmer, and also a significant increase in F0 after voice therapy. No significant changes in jitter or NHR were observed after voice therapy when comparing all patients as one group, but patients whose jitter or NHR measurement before the therapy was over the cutoff values showed a significant improvement.
In this study, 80% of patients had an occupation which requires vocal abuse, and 39% were teachers who work in schools, kindergartens, or nursery schools. Using silence therapy to treat patients whose occupation requires vocal abuse is difficult, and here we showed that voice therapy mainly consisting of vocal hygiene instruction and vocal function exercises could provide improvements without forbidding patients to vocalize.
In 26 out of the 35 (74%) patients, improvements by conservative voice therapy were observed, and the other 9 patients were improved by microscopic laryngeal surgery. Our study showed that voice therapy was effective for vocal fold nodules, and also revealed that some patients required laryngeal microsurgery, suggesting the importance of determining whether the conservative method should be adopted in all cases.
