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Voice Rehabilitation After Early Laryngeal Cancer: A Narrative Review
Yasaman Ekram Nosratian1, Payman Dabirmoghaddam2, Ahmadreza Khatoonabadi3
1MSc in Speech Therapy, Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Objectives:
Early-stage laryngeal cancer, particularly glottic carcinoma, is commonly treated with radiotherapy or transoral CO₂ laser microsurgery. Although these treatments offer favorable oncologic control, voice impairment often persists as a long-term functional concern, affecting quality of life and communication. Voice therapy has been proposed as a rehabilitative intervention to address these voice limitations; however, no standardized protocol currently exists. This narrative review aims to synthesize and critically evaluate the available evidence on voice therapy techniques employed for voice rehabilitation in patients treated for early laryngeal cancer.
Methods:
A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, ScienceDirect, and Google Scholar through May 2026. The search strategy combined terms related to laryngeal cancer and voice therapy using Boolean operators. Studies published in English that investigated voice therapy techniques, protocols, or outcomes following conservative treatment (radiotherapy or transoral laser microsurgery) for early-stage laryngeal cancer were included. Reviews, non-English publications, case reports unrelated to therapy, and papers without an accessible full text were excluded.
Results:
Fifteen studies met the inclusion criteria. Most studies employed structured rehabilitation protocols combining breathing, relaxation, posture, and phonation exercises, typically delivered over 8-10 sessions. Findings consistently indicated that voice therapy provides clinically meaningful improvements in voice-related quality of life, perceptual voice outcomes, and patient-reported voice outcomes, particularly over short- to intermediate-term follow-up periods. Improvements were sustained but partially attenuated over longer follow-up durations. Acoustic outcomes remained variable despite perceptual and functional gains.
Conclusion:
Voice therapy appears to be an effective rehabilitative intervention for improving voice outcomes following conservative treatment for early laryngeal cancer. Structured physiologic voice therapy seems more effective than indirect approaches alone. However, substantial heterogeneity in intervention protocols, outcome measures, and follow-up durations limits direct comparison across studies. Future research should prioritize large-scale controlled trials with standardized multidimensional outcome measures and long-term follow-up to better delineate treatment efficacy and durability.
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