DOI QR코드

DOI QR Code

The Effect of Voice Therapy for the Treatment of Functional Aphonia: A Preliminary Study

기능적 실성증에 대한 음성치료의 효과 분석: 기초 연구

  • Kim, No Eul (Voice-Language Laboratory, Gachon University College of Medicine, Gil Medical Center) ;
  • Kim, Jun Seok (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Oh, Jae Hwan (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Kim, Dong Young (Department of Otohinolaryngology-Head and Neck Surgery, Gachon University College of Medicine, Gil Medical Center) ;
  • Woo, Joo Hyun (Voice-Language Laboratory, Gachon University College of Medicine, Gil Medical Center)
  • 김노을 (가천대학교 의과대학 길병원 이비인후과 음성언어연구실) ;
  • 김준석 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 오재환 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 김동영 (가천대학교 의과대학 길병원 이비인후과학교실) ;
  • 우주현 (가천대학교 의과대학 길병원 이비인후과 음성언어연구실)
  • Received : 2021.03.18
  • Accepted : 2021.04.23
  • Published : 2021.08.31

Abstract

Background and Objectives Functional aphonia refers to in which by presenting whispering voice and almost producing very high-pitched tensed voices are produced. Voice therapy is the most effective treatment, but there is a lack of consensus for application of voice therapy. The purpose of this study was to examine the vocal characteristics of functional aphonia and the effect of voice therapy applied accordingly. Materials and Method From October 2019 to December 2020, 11 patients with functional aphonia were treated using voice therapy which was processing three stages such as vocal hygiene, trial therapy, and behavioral therapy. Of these, 7 patients who completed the voice evaluation before and after voice therapy was enrolled in this study. By retrospective chart review, clinical information such as sex, age, symptoms, duration, social and medical history, process of voice therapy, subjective and objective findings were analyzed. Voice parameters before and after voice therapy were compared. Results In GRBAS study, grade, rough, and asthenic, and in Consensus Auditory-Perceptual Evaluation of Voice, overall severity, roughness, pitch, and loudness were significantly improved after voice therapy. In Voice handicap index, all of the scores of total and sub-categories were significantly decreased. In objective voice analysis, jitter, cepstral peak prominence, and maximum phonation time were significantly improved. Conclusion The voice therapy was effective for the treatment of functional aphonia by restoring patient's vocalization and improving voice quality, pitch and loudness.

Keywords

References

  1. Ruotsalainen JH, Sellman J, Lehto L, Jauhiainen M, Verbeek JH. Interventions for treating functional dysphonia in adults. Cochrane Database Syst Rev 2007;3:CD006373.
  2. Boone DR, McFarlane SC, Von Berg SL. The voice and voice therapy. 7th ed. Boston: Pearson;2005.
  3. Stemple JC, Hapner ER. Voice therapy: Clinical case studies. 5th ed. San Diego: Plural Publishing;2019.
  4. Wendler J. Lehrbuch der Phoniatrie und Padaudiologie. Stuttgart: Thieme;2005.
  5. Ali AI, Osama M, Soha EA, El Kholy MR, Mian FU. Successful management of functional aphonia using a modified voice therapy technique: A case series. Egypt J Otolaryngol 2017;33(4):679-84. https://doi.org/10.4103/ejo.ejo_39_17
  6. Behlau M, Madazio G, Oliveira G. Functional dysphonia: Strategies to improve patient outcomes. Patient Relat Outcome Meas 2015;6:243-53. https://doi.org/10.2147/PROM.S68631
  7. Hillenbrand J, Cleveland RA, Erickson RL. Acoustic correlates of breathy vocal quality. J Speech Hear Res 1994;37(4):769-78. https://doi.org/10.1044/jshr.3704.769
  8. Roy N. Functional dysphonia. Curr Opin Otolaryngol Head Neck Surg 2003;11(3):144-8. https://doi.org/10.1097/00020840-200306000-00002
  9. Cordeiro GF, Montagnoli AN, Nemr NK, Menezes MH, Tsuji DH. Comparative analysis of the closed quotient for lip and tongue trills in relation to the sustained vowel /ε/. J Voice 2012;26(1):e17-22. https://doi.org/10.1016/j.jvoice.2010.07.004
  10. Guzman M, Jara R, Olavarria C, Caceres P, Escuti G, Medina F, et al. Efficacy of water resistance therapy in subjects diagnosed with behavioral dysphonia: A randomized controlled trial. J Voice 2017;31(3):385. e1-385.e10. https://doi.org/10.1016/j.jvoice.2016.09.005
  11. Guzman M, Castro C, Madrid S, Olavarria C, Leiva M, Munoz D, et al. Air pressure and contact quotient measures during different semioccluded postures in subjects with different voice conditions. J Voice 2016;30(6):759.e1-759.e10. https://doi.org/10.1016/j.jvoice.2015.09.010
  12. Angadi V, Croake D, Stemple J. Effects of vocal function exercises: A systematic review. J Voice 2019;33(1):124.e13-124.e34. https://doi.org/10.1016/j.jvoice.2017.08.031
  13. Meerschman I, Bettens K, Dejagere S, Tetaert L, D'haeseleer E, Claeys S, et al. Effect of two isolated vocal-facilitating techniques chant talk and pitch inflections on the phonation of female speech-language pathology students: A pilot study. J Voice 2016;30(6):771.e17-771.e25. https://doi.org/10.1016/j.jvoice.2015.11.007
  14. Titze IR. Interpretation of the electroglottographic signal. J Voice 1990;4(1):1-9. https://doi.org/10.1016/S0892-1997(05)80076-1
  15. Liang FY, Yang JS, Mei XS, Cai Q, Guan Z, Zhang BR, et al. The vocal aerodynamic change in female patients with muscular tension dysphonia after voice training. J Voice 2014;28(3):393.e7-393.e10. https://doi.org/10.1016/j.jvoice.2013.11.010
  16. Konnai R, Scherer RC, Peplinski A, Ryan K. Whisper and phonation: Aerodynamic comparisons across adduction and loudness. J Voice 2017;31(6):773.e11-773.e20. https://doi.org/10.1016/j.jvoice.2017.02.016
  17. Rubin AD, Praneetvatakul V, Gherson S, Moyer CA, Sataloff RT. Laryngeal hyperfunction during whispering: Reality or myth? J Voice 2006;20(1):121-7. https://doi.org/10.1016/j.jvoice.2004.10.007