Treatment options for functional dysphonia

Difficulty in speaking, usually evidenced by hoarseness, can lead to reduced quality of life. In occupations where voice quality is important it might lead to a loss of employment.

The good news? There’s “evidence … for the effectiveness of comprehensive voice therapy.”

Researchers from the Finnish Institute of Occupational Health found 6 studies of 163 treated patients and 141 who served as controls. Treatment groups included:

  • Direct voice therapy
  • Indirect voice therapy
  • Combination of direct and indirect voice therapy
  • Other treatments (pharmacological and vocal hygiene instructions by phoniatrist).

Here are the results.

  • 3 studies supported the effectiveness of combined direct and indirect voice therapy on self-reported vocal functioning, observer-rated vocal functioning, and instrumental assessment of vocal functioning compared to no intervention.
  • In 1 study the remedial effect remained significant for at least 14 weeks based on self-reported vocal functioning and observer-rated vocal functioning (Buffalo Voice Profile).
  • There’s limited evidence that the number of symptoms remain lower for a year.
  • Combined therapy with biofeedback was not more effective than combined therapy alone in one study.
  • Pharmacological treatment was not more effective than vocal hygiene instructions given by phoniatrist.

The bottom line?
Evidence supports comprehensive voice therapy comprising direct and indirect therapy elements.

However, the authors also concluded, “Publication bias may have influenced the results.”

The National Spasmodic Dysphonia Association has more information. It views general voice relaxation techniques and speech therapy as an adjunct in the treatment of spasmodic dysphonia.

10/19/07 21:15 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.