Timing of Voice Therapy: A Primary Investigation of Voice Outcomes for Surgical Benign Vocal Fold Lesion Patients

J Voice. 2017 Jan;31(1):129.e1-129.e7. doi: 10.1016/j.jvoice.2015.12.005. Epub 2016 Jan 14.

Abstract

Objective: This study aims to examine the role of timing of speech-language pathology intervention on outcomes for surgical patients with benign vocal fold lesions as measured by a patient self-reported scale (Voice Handicap Index [VHI]) and objective acoustic measures (jitter %, Dysphonia Severity Index, noise-to-harmonics ratio). For the purpose of this study, interventions were categorized into three groups: preoperative (preoperative counseling session followed by postoperative therapy), pre- and postoperative therapy (multiple therapy sessions preoperatively and postoperatively), and postoperative therapy alone.

Study design: Retrospective review of a prospective disease-specific outcomes database.

Methods: Subjects identified in the database consisted of 12 preoperative counseling participants (six male, six female), 11 pre- and postoperative therapy participants (three male, eight female), and eight postoperative therapy only participants (three male, five female). Preoperative and postoperative VHI, Dysphonia Severity Index, jitter, and noise-to-harmonics ratio scores were compared between groups using paired t tests with a multiple comparison Bonferroni correction (α = 0.016).

Results: Despite lack of statistically significant changes in acoustic measures, groups receiving preoperative intervention whether with postoperative therapy or not, had statistically significant improvements in their VHI total scores (P = 0.001 for preoperative only and P = 0.0002 for pre- and postoperative therapy).

Conclusions: Patients receiving speech pathology services before surgery for benign vocal fold lesions with or without postoperative therapy demonstrated greater gains in their subjective view of vocal function and quality as measured by the VHI.

Keywords: Benign vocal fold lesions; Perioperative therapy; Preoperative counseling; Voice Outcomes; Voice therapy.

MeSH terms

  • Acoustics
  • Adolescent
  • Adult
  • Databases, Factual
  • Disability Evaluation
  • Female
  • Humans
  • Laryngeal Diseases / complications
  • Laryngeal Diseases / diagnosis
  • Laryngeal Diseases / physiopathology
  • Laryngeal Diseases / therapy*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Recovery of Function
  • Retrospective Studies
  • Self Concept
  • Speech Acoustics*
  • Speech Perception
  • Speech Production Measurement
  • Speech-Language Pathology / methods
  • Time Factors
  • Time-to-Treatment*
  • Treatment Outcome
  • Vocal Cords / physiopathology
  • Vocal Cords / surgery*
  • Voice Disorders / diagnosis
  • Voice Disorders / etiology
  • Voice Disorders / physiopathology
  • Voice Disorders / therapy*
  • Voice Quality*
  • Voice Training*
  • Young Adult