Ospedale Maggiore, ENT Department, Lodi, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.
Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy.
J Voice. 2024 Jan;38(1):245.e17-245.e35. doi: 10.1016/j.jvoice.2021.06.009. Epub 2021 Jul 18.
Dysphonia is a disorder characterized by an alteration in the overall quality of the voice which reduces quality of life. Therefore, we assessed the effectiveness of SOVTEs in the management of dysfunctional and organic dysphonia for acoustic, perceptual-auditive, aerodynamic parameters and self-perception of the disease.
a systematic review and meta-analysis were conducted. Findings were reported according to the PRISMA statement. Five databases were searched for RCTs and non- or quasi-RCTs. Studies were independently assessed using the Cochrane Risk of bias (RoB) and ROBINS-I tools. Effect sizes (ES) were calculated only at post-treatment. GRADE criteria were used to assess the quality of evidence.
eight articles were included. Studies investigated several SOVTEs, alone or in combination. None of the study was completely judged at low RoB. The quality of evidence resulted very low for each analysis. SOVTEs revealed to be statistically more effective than control interventions in improving F0 (ES: -14.42; CI 95%: -27.16, -1.69); P = 0.03), whereas shimmer did not change significantly (ES: -0.43; CI 95%:-02.02, 1.15; P = 0.59). Not significant changes in favor of control groups were found for jitter (ES: 0.13; CI 95%: -0.14, 0.40; P = 0.34) and overall gravity in the perceptual-auditory evaluation (ES: 0.13 CI 95%: -0.50, 0.77; P = 0. 68). Among secondary outcomes, evidence suggested that SOVTEs are more effective than control interventions in Psub reduction (ES: -1.47; CI 95%: -2.84, -0.10; P = 0.03); self-assessment resulted not significantly in favor of SOVTEs (VHI/VRQoL: ES -0.23; CI 95% -1.14, 0.69; P = 0.63 and VTDS/VDSI: ES -4.85, CI 95% -25.13, 15.42; P = 0.64).
results obtained showed that voice therapy based on SOVTEs is not to consider significantly superior if compared to other treatments, even if a favorable trend was detected and should be taken into consideration. Further high-quality RCTs on specific SOVTEs are recommended to produce better-quality evidence.
发音障碍是一种以整体声音质量改变为特征的疾病，降低了生活质量。因此，我们评估了 SOVTE 在功能性和器质性发音障碍的管理中的有效性，用于评估声学、感知听觉、空气动力学参数和疾病的自我认知。
进行了系统评价和荟萃分析。根据 PRISMA 声明报告研究结果。在五个数据库中检索 RCT 和非 RCT 或准 RCT。使用 Cochrane 风险偏倚（RoB）和 ROBINS-I 工具独立评估研究。仅在治疗后计算效应大小（ES）。使用 GRADE 标准评估证据质量。
纳入了 8 篇文章。研究调查了几种 SOVTE，单独或联合使用。没有一项研究被完全判断为低 RoB。对于每项分析，证据质量均非常低。SOVTE 与对照组相比，在改善 Fo（ES：-14.42；CI 95%：-27.16，-1.69）方面显示出统计学上的更有效性；P=0.03），而颤音没有显著变化（ES：-0.43；CI 95%：-02.02，1.15；P=0.59）。在感知听觉评估中，没有发现有利于对照组的抖动（ES：0.13；CI 95%：-0.14，0.40；P=0.34）和整体重力的显著变化。在次要结果中，证据表明 SOVTE 在 Psub 减少方面比对照组更有效（ES：-1.47；CI 95%：-2.84，-0.10；P=0.03）；自我评估结果对 SOVTE 没有明显的益处（VHI/VRQoL：ES -0.23；CI 95% -1.14，0.69；P=0.63 和 VTDS/VDSI：ES -4.85，CI 95% -25.13，15.42；P=0.64）。
研究结果表明，与其他治疗方法相比，基于 SOVTE 的语音治疗并不明显优越，尽管检测到有利趋势，但仍应考虑在内。建议进一步开展高质量的关于特定 SOVTE 的 RCT，以产生更高质量的证据。
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