Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan; Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan.
Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan.
J Formos Med Assoc. 2022 Jan;121(1 Pt 2):329-334. doi: 10.1016/j.jfma.2021.05.004. Epub 2021 May 25.
BACKGROUND/PURPOSE: Voice therapy is frequently recommended as the first-line treatment for benign voice disorders. This study investigated the clinical effectiveness of voice therapy and the prognostic factors of treatment outcomes.
We recruited 103 consecutive patients with voice disorders, namely vocal nodules, polyps, and muscle tension dysphonia (MTD), from September 2014 to July 2016. All the patients received voice therapy as the primary treatment. Treatment outcomes were evaluated using auditory perceptual evaluation, acoustic analysis, maximum phonation time, and 10-item voice handicap index (VHI-10). Clinical effectiveness of voice therapy was defined by either 1) a posttreatment VHI-10 score ≤ 10 points or 2) decline of VHI-10 ≥ 4 points.
After voice therapy, VHI-10 and perceptual rating of voice quality improved significantly (p < 0.05) in the three disease categories. In patients with nodules, all the outcome parameters improved significantly (p < 0.05). Patients with good adherence to voice therapy (attending more than four sessions) had a significantly higher effectiveness than those with poor adherence (87% vs. 64%, p < 0.05). Patients with high occupational vocal demand also demonstrated a better effectiveness than those with routine vocal demand (90% vs. 70%, p < 0.05). Subsequent multivariate analyses revealed that adherence and vocal demand were independently and significantly correlated with clinical effectiveness (p = 0.03).
Voice therapy is effective for patients with vocal nodules, polyps, and MTD. Adherence to voice therapy and occupational vocal demand are significant prognostic factors for treatment outcomes.
背景/目的：语音治疗通常被推荐为治疗良性嗓音障碍的一线治疗方法。本研究旨在调查语音治疗的临床疗效以及治疗结果的预后因素。
我们招募了 2014 年 9 月至 2016 年 7 月期间连续的 103 名患有嗓音障碍的患者，包括声带小结、息肉和肌紧张性发音障碍（MTD）。所有患者均接受语音治疗作为主要治疗方法。治疗效果通过听觉感知评估、声学分析、最长发声时间和 10 项嗓音障碍指数（VHI-10）进行评估。语音治疗的临床疗效定义为：1）治疗后 VHI-10 评分≤10 分，或 2）VHI-10 下降≥4 分。
语音治疗后，三种疾病类型的 VHI-10 和嗓音质量的听觉感知评分均显著改善（p<0.05）。在声带小结患者中，所有的结果参数均显著改善（p<0.05）。与依从性差（参加治疗少于 4 次）的患者相比，依从性好（参加治疗多于 4 次）的患者治疗效果显著更高（87%比 64%，p<0.05）。职业嗓音需求高的患者的治疗效果也明显优于职业嗓音需求常规的患者（90%比 70%，p<0.05）。随后的多变量分析显示，依从性和职业嗓音需求与临床疗效独立且显著相关（p=0.03）。
语音治疗对声带小结、息肉和 MTD 患者有效。对语音治疗的依从性和职业嗓音需求是治疗结果的重要预后因素。
