title: Multidimensional assessment of vocal changes in benign vocal fold lesions after voice therapy.
abstract: OBJECTIVE
  To evaluate through a multidimensional protocol voice changes after voice therapy in patients with benign vocal fold lesions.
  
  
  METHODS
  65 consecutive patients affected by benign vocal fold lesions were enrolled. Depending on videolaryngostroboscopy the patients were divided into 3 groups: 23 patients with Reinke's oedema, 22 patients with vocal fold cysts and 20 patients with gelatinous polyp. Each subject received 10 voice therapy sessions and was evaluated, before and after voice therapy, through a multidimensional protocol including videolaryngostroboscopy, perception, acoustics, aerodynamics and self-rating by the patient. Data were compared using Wilcoxon signed-rank test. Kruskal-Wallis test was used to analyse the mean variation difference between the three groups of patients. Mann-Whitney test was used for post hoc analysis.
  
  
  RESULTS
  Only in 11 cases videolaryngostroboscopy revealed an improvement of the initial pathology. However a significant improvement was observed in perceptual, acoustic and self-assessment ratings in the 3 groups of patients. In particular the parameters of G, R and A of the GIRBAS scale, and the noise to harmonic ratio, Jitter and shimmer scores improved after rehabilitation. A significant improvement of all the parameters of Voice Handicap Index after rehabilitation treatment was found. No significant difference among the three groups of patients was visible, except for self-assessment ratings.
  
  
  CONCLUSIONS
  Voice therapy may provide a significant improvement in perceptual, acoustic and self-assessed voice quality in patients with benign glottal lesions. Utilization of voice therapy may allow some patients to avoid surgical intervention.
authors.affiliation: Department of Clinical Sciences L. Sacco, University of Milan, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Schindler
authors.forename: Francesco
authors.initials: F
authors.lastname: Mozzanica
authors.forename: Patrizia
authors.initials: P
authors.lastname: Maruzzi
authors.forename: Murat
authors.initials: M
authors.lastname: Atac
authors.forename: Valeria
authors.initials: V
authors.lastname: De Cristofaro
authors.forename: Francesco
authors.initials: F
authors.lastname: Ottaviani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003560:Cysts / Q000503:physiopathology / Q000628:therapy; D004487:Edema / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000503:physiopathology / Q000628:therapy; D013061:Speech Acoustics; D013067:Speech Perception / Q000502:physiology; D049489:Stroboscopy; D014741:Video Recording; D014827:Vocal Cords / Q000503:physiopathology*; D014833:Voice Quality / Q000502:physiology; D014834:Voice Training; D055815:Young Adult