Is voice therapy an effective treatment for dysphonia? A randomised controlled trial.
OBJECTIVE
To assess the overall efficacy of voice therapy for dysphonia.


METHODS
Single blind randomised controlled trial.


METHODS
Outpatient clinic in a teaching hospital.


METHODS
204 outpatients aged 17-87 with a primary symptom of persistent hoarseness for at least two months.


METHODS
After baseline assessments, patients were randomised to six weeks of either voice therapy or no treatment. Assessments were repeated at six weeks on the 145 (71%) patients who continued to this stage and at 12-14 weeks on the 133 (65%) patients who completed the study. The assessments at the three time points for the 70 patients who completed treatment and the 63 patients in the group given no treatment were compared.


METHODS
Ratings of laryngeal features, Buffalo voice profile, amplitude and pitch perturbation, voice profile questionnaire, hospital anxiety and depression scale, clinical interview schedule, SF-36.


RESULTS
Voice therapy improved voice quality as assessed by rating by patients (P=0.001) and rating by observer (P<0.001). The treatment effects for these two outcomes were 4.1 (95% confidence interval 1.7 to 6.6) points and 0.82 (0.50 to 1.13) points. Amplitude perturbation showed improvement at six weeks (P=0.005) but not on completion of the study. Patients with dysphonia had appreciable psychological distress and lower quality of life than controls, but voice therapy had no significant impact on either of these variables.


CONCLUSIONS
Voice therapy is effective in improving voice quality as assessed by self rated and observer rated methods.
MacKenzie
K
K
Department of Otorhinolaryngology and Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow G31 2ER. kmk2x@clinm,ed.gla.ac.uk
Millar
A
A
Wilson
J A
JA
Sellars
C
C
Deary
I J
IJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology; D003866:Depressive Disorder / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016037:Single-Blind Method; D016896:Treatment Outcome; D014832:Voice Disorders / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D014833:Voice Quality; D014834:Voice Training