Does Voice Therapy Improve Vocal Outcomes in Vocal Fold Atrophy?

Area of Science:

• Gerontology
• Otolaryngology
• Speech-Language Pathology

Background:

• Vocal fold atrophy is a growing concern in the elderly population.
• Outcomes of voice therapy for vocal fold atrophy vary, necessitating further analysis.
• Multidimensional vocal assessments are crucial for understanding treatment efficacy.

Purpose of the Study:

• To analyze multidimensional vocal outcomes in patients with vocal fold atrophy undergoing voice therapy.
• To determine patient compliance with recommended voice therapy.
• To compare outcomes between patients receiving voice therapy and those undergoing surgery.

Main Methods:

• A retrospective review of 197 patients diagnosed with vocal fold atrophy.
• Categorization of patients based on treatment received: no therapy, incomplete therapy, complete therapy, surgery only, or therapy followed by surgery.
• Analysis of patient-reported, perceptual, aerodynamic, and acoustic voice outcomes pre- and post-intervention using Wilcoxon signed-rank and rank-sum tests.

Main Results:

• Only 29% of patients completed recommended voice therapy.
• Complete voice therapy led to significant improvements in voice-related quality of life (VRQOL), glottal function index (GFI), GRBAS scores, maximum phonation time (MPT), and fundamental frequency in women.
• No significant changes were observed in mean airflow. Pre-treatment VRQOL and GFI differed significantly between surgery and voice therapy groups.

Conclusions:

• Voice therapy demonstrates significant multidimensional benefits for patients with vocal fold atrophy.
• Low compliance with voice therapy recommendations is a key challenge in this population.
• Pre-treatment patient-reported measures distinguish surgical candidates from those treated with voice therapy alone.