Shelly Sandeep, Rothenberger Scott D, Gartner-Schmidt Jackie, Gillespie Amanda I
Department of Otolaryngology-Head and Neck Surgery, Emory Voice Center, Emory University, Atlanta, Georgia.
Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Voice. 2025 Jul;39(4):1109-1113. doi: 10.1016/j.jvoice.2023.02.008. Epub 2023 Mar 10.
Voice therapy is the primary treatment modality for voice rehabilitation. Specific patient-ability factors beyond patient-characteristic factors (eg, disorder diagnosis, age, etc.), that influence individual patient responses to voice treatment remain largely unknown. The goal of the current study was to determine the relationship between patient-perceived improvements in both the sound and feel of voice during stimulability assessment and voice therapy outcomes.
Prospective Cohort study.
This study was a single-arm, single-center, prospective study. Fifty patients with primary muscle tension dysphonia and benign vocal fold lesions were enrolled. Patients read the first four sentences of the Rainbow Passage and were asked if they experienced a change in the feel or sound of their voice following the stimulability prompt. Patients then completed four sessions of conversation training therapy (CTT) voice therapy and followed up one-week and three-months after their last therapy session, for a total of six time-points. Demographic data were collected at baseline, and voice handicap index 10 (VHI-10) scores were collected at each follow-up time-point. The primary exposure variables were CTT intervention and patient perception of voice change to stimulability probes. The primary outcome was change in VHI-10 score.
On average, VHI-10 scores improved for all participants following CTT treatment. All participants heard a change in the sound of voice with stimulability prompts. Descriptively, patients who reported a positive change in the feel of their voice after stimulability testing recovered faster (ie, experienced a sharper decline in VHI-10) compared to those who did not note a change in feel of voice during stimulability testing. However, the rate of change over time was not significantly different between groups.
Patient self-perception of a change in the sound and feel of voice in response to stimulability probes during initial evaluation is an important factor in treatment outcomes. Patients who perceive an improved feel of their voice production after stimulability probes may respond to voice therapy more quickly.
嗓音治疗是嗓音康复的主要治疗方式。除患者特征因素（如疾病诊断、年龄等）外，影响个体患者对嗓音治疗反应的特定患者能力因素在很大程度上仍不明确。本研究的目的是确定在可激发性评估和嗓音治疗结果期间患者所感知的嗓音音质和感觉改善之间的关系。
前瞻性队列研究。
本研究为单臂、单中心前瞻性研究。招募了50例原发性肌肉紧张性发声障碍和良性声带病变患者。患者朗读《彩虹段落》的前四句话，并被询问在可激发性提示后他们的嗓音感觉或音质是否有变化。然后患者完成四个疗程的对话训练疗法（CTT）嗓音治疗，并在最后一次治疗疗程后1周和3个月进行随访，共六个时间点。在基线时收集人口统计学数据，并在每个随访时间点收集嗓音障碍指数10（VHI-10）评分。主要暴露变量为CTT干预和患者对可激发性探针的嗓音变化感知。主要结局为VHI-10评分的变化。
平均而言，所有参与者在CTT治疗后VHI-10评分均有所改善。所有参与者在可激发性提示后都听到了嗓音音质的变化。描述性地，与在可激发性测试期间未注意到嗓音感觉变化的患者相比，那些在可激发性测试后报告嗓音感觉有积极变化的患者恢复得更快（即VHI-10下降更明显）。然而，两组随时间的变化率没有显著差异。
患者在初始评估期间对可激发性探针所感知的嗓音音质和感觉变化是治疗结果的一个重要因素。在可激发性探针后感知到嗓音发声感觉改善的患者可能对嗓音治疗反应更快。
