title: Timing of Voice Therapy: A Primary Investigation of Voice Outcomes for Surgical Benign Vocal Fold Lesion Patients.
abstract: OBJECTIVE
  This study aims to examine the role of timing of speech-language pathology intervention on outcomes for surgical patients with benign vocal fold lesions as measured by a patient self-reported scale (Voice Handicap Index [VHI]) and objective acoustic measures (jitter %, Dysphonia Severity Index, noise-to-harmonics ratio). For the purpose of this study, interventions were categorized into three groups: preoperative (preoperative counseling session followed by postoperative therapy), pre- and postoperative therapy (multiple therapy sessions preoperatively and postoperatively), and postoperative therapy alone.
  
  
  METHODS
  Retrospective review of a prospective disease-specific outcomes database.
  
  
  METHODS
  Subjects identified in the database consisted of 12 preoperative counseling participants (six male, six female), 11 pre- and postoperative therapy participants (three male, eight female), and eight postoperative therapy only participants (three male, five female). Preoperative and postoperative VHI, Dysphonia Severity Index, jitter, and noise-to-harmonics ratio scores were compared between groups using paired t tests with a multiple comparison Bonferroni correction (α = 0.016).
  
  
  RESULTS
  Despite lack of statistically significant changes in acoustic measures, groups receiving preoperative intervention whether with postoperative therapy or not, had statistically significant improvements in their VHI total scores (P = 0.001 for preoperative only and P = 0.0002 for pre- and postoperative therapy).
  
  
  CONCLUSIONS
  Patients receiving speech pathology services before surgery for benign vocal fold lesions with or without postoperative therapy demonstrated greater gains in their subjective view of vocal function and quality as measured by the VHI.
authors.affiliation: University of Wisconsin-Madison Voice and Swallow Clinics, 600 Highland Ave, Madison, Wisconsin 53792.
authors.forename: Sharon S
authors.initials: SS
authors.lastname: Tang
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, 5107 WIMR, 1111 Highland Avenue, Madison, Wisconsin 53705.. Electronic address: thibeault@surgery.wisc.edu.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Thibeault
mesh_terms: D000162:Acoustics; D000293:Adolescent; D000328:Adult; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D012649:Self Concept; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D013066:Speech-Language Pathology / Q000379:methods; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014832:Voice Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult
keywords: Benign vocal fold lesions; Perioperative therapy; Preoperative counseling; Voice Outcomes; Voice therapy