title: Randomized controlled trial of supplemental augmentative and alternative communication versus voice rest alone after phonomicrosurgery.
abstract: OBJECTIVE
  This randomized trial investigated voice rest and supplemental text-to-speech communication versus voice rest alone on visual analog scale measures of communication effectiveness and magnitude of voice use.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Multicenter outpatient voice clinics.
  
  
  METHODS
  Thirty-seven patients undergoing phonomicrosurgery.
  
  
  METHODS
  Patients undergoing phonomicrosurgery were randomized to voice rest and supplemental text-to-speech communication or voice rest alone. The primary outcome measure was the impact of voice rest on ability to communicate effectively over a 7-day period. Pre- and postoperative magnitude of voice use was also measured as an observational outcome.
  
  
  RESULTS
  Patients randomized to voice rest and supplemental text-to-speech communication reported higher median communication effectiveness on each postoperative day compared to those randomized to voice rest alone, with significantly higher median communication effectiveness on postoperative days 3 (P=.03) and 5 (P=.01). Magnitude of voice use did not differ on any preoperative (P>.05) or postoperative day (P>.05), nor did patients significantly decrease voice use as the surgery date approached (P>.05). However, there was a significant reduction in median voice use pre- to postoperatively across patients (P<.001) with median voice use ranging from 0 to 3 throughout the postoperative week.
  
  
  CONCLUSIONS
  Supplemental text-to-speech communication increased patient-perceived communication effectiveness on postoperative days 3 and 5 over voice rest alone. With the prevalence of smartphones and the widespread use of text messaging, supplemental text-to-speech communication may provide an accessible and cost-effective communication option for patients on vocal restrictions.
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA bernard.rousseau@vanderbilt.edu.
authors.forename: Bernard
authors.initials: B
authors.lastname: Rousseau
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Gutmann
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: Mau
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: David O
authors.initials: DO
authors.lastname: Francis
authors.affiliation: Boston University, Boston, Massachusetts, USA.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Johnson
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: Carolyn K
authors.initials: CK
authors.lastname: Novaleski
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: Kimberly N
authors.initials: KN
authors.lastname: Vinson
authors.affiliation: Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: C Gaelyn
authors.initials: CG
authors.lastname: Garrett
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011184:Postoperative Period; D012146:Rest / Q000502:physiology*; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014831:Voice / Q000502:physiology*; D014832:Voice Disorders / Q000503:physiopathology / Q000601:surgery*; D014834:Voice Training; D055815:Young Adult
keywords: augmentative and alternative communication; randomized controlled trial; text-to-speech; voice; voice disorders; voice rest