Assessment of the influence of osteopathic myofascial techniques on normalization of the vocal tract functions in patients with occupational dysphonia.
OBJECTIVE
Occupational voice disorders are accompanied by increased tension of the external laryngeal muscle which changes the position of the larynx and consequently disturbs the conditions of functioning of the vocal tract. The aim of the study is to assess the use of osteopathic procedures in the diagnosis and treatment of occupational dysphonia.


METHODS
Study subjects included 40 teachers with chronic diseases of the voice organ (38 women and 2 men) aged from 39 to 59 (mean age: 48.25). Before and after the voice therapy the osteopathic examination according to Libermann's protocol was performed as well as phoniatric examination including laryngovideostroboscopy (LVSS), assessment of the maximum phonation time (MPT) and the Voice Handicap Index (VHI) score. The voice therapy, scheduled and supervised by a laryngologist-phoniatrician and conducted by a speech-language pathologist, was supplemented with osteopathic myofascial rehabilitation of the larynx. The chi-square McNemar test and non-parametric Wilcoxon matched pairs test were applied in the statistical assessment.


RESULTS
The applied interdisciplinary treatment including osteopathic and vocal therapy resulted in a statistically significant decrease in tenderness of muscles raising the larynx (cricothyroid ligament, sternocleidomastoid muscles, and pharyngeal constrictor muscles) and in lowering the tonus (geniohyoid muscles, pharyngeal constrictor muscles and sternocleidomastoid muscles). A significant improvement was also observed in the case of dysfunction of the cricothyroid joint examined during glissando and yawning, as well as in asymmetry of the thyrohyoid apparatus. Moreover, the therapy resulted in significantly better normalization of the head position and better control of the centre of gravity of the body. Statistically significant post-therapy improvement was observed in the phoniatric examination, including VHI scores, MPT results and parameters of videostroboscopic examination.


CONCLUSIONS
The use of osteopathic therapy helps significantly improve the functions of the vocal tract in patients with occupational dysphonia.
Faculty of Physical Education, Sport and Rehabilitation, University School of Physical Education in Poznań, Poznań, Poland. marszaleksl@wp.pl
Sławomir
S
Marszałek
Ewa
E
Niebudek-Bogusz
Ewelina
E
Woźnicka
Joanna
J
Malińska
Wojciech
W
Golusiński
Mariola
M
Śliwińska-Kowalska
D000328:Adult; D055154:Dysphonia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007830:Larynx / Q000503:physiopathology; D008297:Male; D026301:Manipulation, Osteopathic / Q000379:methods*; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D011044:Poland; D011795:Surveys and Questionnaires; D013663:Teaching; D016896:Treatment Outcome