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Management of benign vocal fold lesions

current perspectives on the role for voice therapy

White, Anna

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2019 - Volume 27 - Issue 3 - p 185–190
doi: 10.1097/MOO.0000000000000536
SPEECH THERAPY AND REHABILITATION: Edited by H. Fiona Robinson and Jo Patterson

Purpose of review Benign vocal fold lesions (BVFLs) cause dysphonia by preventing full vocal fold closure, interrupting vibratory characteristics and increasing compensatory muscle tension. Management includes phonosurgery, voice therapy, pharmacological treatment or more commonly a combination of these interventions. This review aims to present current perspectives on the management of BVFLs, particularly exploring the role of voice therapy.

Recent findings The review highlights variation in the management of BVFLs. There is evidence that phonosurgery is a well tolerated and effective intervention for BVFLs. Primary voice therapy can frequently prevent surgery in vocal fold nodules and some types of polyps. Used as an adjunct to phonosurgery, preoperative and postoperative voice therapy can improve patient-reported outcomes and acoustic parameters of the voice. However, heterogeneity of studies and poor descriptions of intervention components prevent a robust analysis of the impact of voice therapy.

Summary The current evidence consists of low-level studies using mixed aetiology groups, which compromises internal and external validity. There are a few exceptions to this. Poor reporting and heterogeneous methodologies lead to difficulties determining the components of a voice therapy intervention for this population. Consequently, we are unable to evaluate, which intervention elements are beneficial to patients.

Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK

Correspondence to Anna White, Highly Specialist Speech and Language Therapist, Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham NG5 1PB, UK. Tel: +44 115 9709221; fax: +44 115 9709221; e-mail:

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