Interventions for treating functional dysphonia in adults

Area of Science:

• Otolaryngology
• Speech-Language Pathology
• Rehabilitation Medicine

Background:

• Functional dysphonia significantly impairs quality of life and can lead to job loss in vocally demanding professions.
• Effective treatments for functional dysphonia are crucial for patient well-being and occupational sustainability.

Purpose of the Study:

• To systematically evaluate the effectiveness of various interventions for treating functional dysphonia in adults.
• To synthesize evidence from randomized controlled trials (RCTs) and other relevant study designs.

Main Methods:

• Conducted a comprehensive literature search across multiple databases (MEDLINE, EMBASE, CENTRAL, CINAHL, PsychINFO, Science Citation Index, OSH-ROM) up to April 2006.
• Included RCTs of interventions for functional dysphonia in adults; interrupted time series and prospective cohort studies were eligible for work-directed interventions.
• Data extraction and quality assessment were performed independently by two authors, with meta-analysis conducted where appropriate.

Main Results:

• Six RCTs involving 163 participants in intervention groups and 141 controls were identified; only one trial was of high quality.
• Combined direct and indirect voice therapy demonstrated effectiveness in improving self-reported, observer-rated, and instrumentally assessed vocal functioning compared to no intervention.
• The positive effects of combined therapy were sustained for at least 14 weeks, with some evidence of symptom reduction persisting for a year. Other interventions, like pharmacological treatment, showed no significant advantage over basic vocal hygiene instructions.

Conclusions:

• There is evidence supporting the efficacy of comprehensive voice therapy that integrates both direct and indirect therapeutic elements.
• The positive outcomes of this combined approach are consistent across patient populations, including those in vocally demanding professions like teachers.
• Further research with larger sample sizes and improved methodological rigor, utilizing outcome measures aligned with treatment objectives, is recommended.