Remote Voice Therapy for Vocal Nodules: Clinical Effectiveness and Satisfaction in a Thai Cohort

This study aims to develop and evaluate the effectiveness of telepractice for delivering voice therapy to patients with vocal fold nodules (VFNs), comparing the results of voice assessments before and after voice therapy.

Multicenter experimental research.

The study included 12 participants diagnosed with VFNs. Each participant received voice therapy in 10 sessions across 10 weeks through telepractice using the Zoom cloud meeting application. Outcome measurements included auditory-perceptual assessment, acoustic analysis, maximum phonation time (MPT), and the Voice Handicap Index (VHI), which were taken before and after treatment. Participants also completed a telepractice satisfaction questionnaire within two weeks after treatment.

The Wilcoxon signed-ranks test reveals a significant improvement in grade, instability, breathiness, and strained scores. However, there were no significant differences for roughness and asthenic. Fundamental frequency increased from 177.02 ± 25.77 to 200.29 ± 28.02, which was statistically significant. Jitter, shimmer, noise-to-harmonic ratio, and MPT were also significant improvements. VHI scores decreased from 62.58 ± 18.63 to 37.25 ± 15.33, which was statistically significant. Furthermore, the participants reported a high level of satisfaction with the telepractice voice therapy.

The results show that voice therapy via telepractice improved objective and subjective voice parameters, indicating that telepractice should be considered a therapeutic option for patients with VFNs.