A Review of Voice Therapy Techniques Employed in Treatment of Dysphonia with and Without Vocal Fold Lesions
- 390 Downloads
Purpose of Review
The purpose of the review is to provide otolaryngologists a framework for understanding voice evaluation by speech-language pathologists and the voice therapy techniques they employ.
Recent reports have demonstrated the efficacy of behavioral voice therapy in the management of a variety of types of dysphonia, including those associated with vocal fold lesions and those without.
Otolaryngologists can be experts in managing specific laryngeal lesions to improve voice. However, not all voice problems have lesions amenable to surgical or medical therapies. Many are associated with maladaptive voicing behaviors. Speech-language pathologists can be experts in both the evaluation of vocal function and technique. They may employ a variety of techniques to improve vocal quality and function in patients with and without structural or neurologic laryngeal pathology. Otolaryngologists can partner to manage a constellation of voice problems with directed voice evaluation and therapy. A basic review of these techniques and this partnership with voice therapists is presented.
KeywordsVoice therapy Phonosurgery Muscle tension dysphonia Laryngeal pathology Laryngeal hyperfunction Dysphonia
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Karen Drake, Dr. Linda Bryans, and Dr. Joshua S. Schindler declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 1.Lessac A. The use and training of the human voice: a practical approach to speech and voice dynamics. New York: Drama Book; 2012.Google Scholar
- 2.• Verdolini-Marston K, Burke MK, Lessac A, Glaze L, Caldwell E. Preliminary study of two methods of treatment for laryngeal nodules. J Voice. 1995;9(1):74–85. Resonant Voice Therapy is employed by most voice clinicians for many different types of conditions affecting the voice. This paper is the only controlled study that has provided some evidence that this approach may be beneficial in the treatment of vocal nodules. This is a seminal article on which subsequent research has been based. Google Scholar
- 4.• Stemple JC, Lee L, D’Amico B, Pickup B. Efficacy of vocal function exercises as a method of improving voice production. J Voice 1994;8(3):271–8. Stemple et al introduced a set of exercises based on a physiologic model of voice therapy which include a series of voice manipulations that were designed to strengthen and balance the laryngeal musculature as well as the coordinated interaction of respiration, phonation and resonance. This is a seminal article on which subsequent research has been based. These are exercises most voice clinicians use as a part of any voice therapy program. Google Scholar
- 5.Colton R, Casper J, Leonard R. Understanding voice problems: a physiological perspective for diagnosis and treatment. Baltimore: Lippincott, Williams & Wilkins; 2011.Google Scholar
- 6.Stone RS, Casteel RL. Restoration of voice in nonorganically based dysphonias. In: Filter M, editor. Phonatory voice disorders in children. Springfield: Charles C. Thomas; 1982.Google Scholar
- 8.Aronson AE. Clinical voice disorders: an interdisciplinary approach. New York: Brian C. Decker; 1985.Google Scholar
- 12.Barkmeier-Kraemer J, Lato A, Wiley K. Development of a speech treatment program for a client with essential vocal tremor. In: Seminars in speech and language pathology 2011;32(1).Google Scholar
- 13.• Ramig LO, Countryman S, O’Brien C, Hoehn M, Thompson L. Intensive voice treatment (LSVT®) for patients with Parkinson’s disease: a 2 year follow up. J Neurol Neurosurg Psychiatry 2001;71(4): 493–8. LSVT is the most researched approach in all areas of voice therapy. This article demonstrates the efficacy of this treatment as well as the long term effectiveness in persons with Parkinson Disease. Google Scholar
- 16.Sapir S, Pawlas AA, Ramig LO, Seeley E, Fox C, Corboy J. Effects of intensive phonatory-respiratory treatment (LSVT) on voice in two individuals with multiple sclerosis. J Med Speech-Lang Pathol. 2001;9:141–51.Google Scholar