Research Articles:
1.) Safari, M., Ghprban, A., Amiri, S., Izadi, F. (2011) Effects of voice therapy on vocal acoustic characteristics in patients with vocal cord nodules.
Background and Aim: Vocal cord nodule is one of the voice disorders causes hoarseness and breathy voice. Voice therapy is one of the treatment approaches. We aimed to find out the effects of voice therapy on vocal acoustic characteristics in these patients. Methods: In this case series, five women with vocal nodule (14 to 45-year-old) participated in a 9- week voice therapy program developed by Boone. Vocal hygiene and voice practices were measured every day using a questionnaire. Moreover, structure and movements of vocal folds were examined using videolaryngostroboscope by a laryngologist before and after voice therapy to evaluate the effectiveness of program. For collecting voice samples we used sustained /æ/ in comfortable loudness for all patients and data were analyzed using Speech Studio. Results: After voice therapy, fundamental frequency in four of five subjects were decreased but it was not significant (p=0.225). However, jitter in all of five subjects was significantly decreased (p=0.043). After voicetherapy, shimmer in three of five subjects were decreased that was not significant (p=0.345). Conclusion: Voice therapy can be used for the remedy of acoustic vocalcharacteristics and elimination or contraction of vocal cord nodule.
2.) Tezcaner, C., Ozgursoy, S., Sati, I.,& Dursun, G. (2009). Changes after voice therapy in objective and
subjective voice measurements of pediatric patients with vocal nodules. European Archives Of Oto-Rhino-Laryngology, 266(12), 1923-1927.doi:10.1007/s00405-009-1008-6
The aim of this study was to analyze the efficiency of the voice therapy in children with vocal nodules by using the acoustic analysis and subjective assessment. Thirty-nine patients with vocal fold nodules, aged between 7 and 14, were included in the study. Each subject had voice therapy led by an experienced voice therapist once a week. All diagnostic and follow-up workouts were performed before the voice therapy and after the third or the sixth month. Transoral and/or transnasal videostroboscopic examination and acoustic analysis were achieved using multi-dimensional voice program (MDVP) and subjective analysis with GRBAS scale. As for the perceptual assessment, the difference was significant for four parameters out of five. A significant improvement was found in the acoustic analysis parameters of jitter, shimmer, and noise-to-harmonic ratio. The voice therapy which was planned according to patients’ needs, age, compliance and response to therapy had positive effects on pediatric patients with vocal nodules. Acoustic analysis and GRBAS may be used successfully in the follow-up of pediatric vocal nodule
treatment.
3.) Halawa, W., García, A., & Pérez, S. (2013). Effectiveness of laryngostroboscopy for monitoring the evolution of vocal nodules after rehabilitator treatment. Auris Nasus Larynx, 40(2), 204-206. doi:10.1016/j.anl.2012.06.004
Objective: The aim of this study is to evaluate the effectiveness of the laryngostroboscopy for monitoring the evolution of patients with vocal nodules before and after the logopedic vocal treatment. Methods: We performed a prospective observational study of 97 dysphonic patients diagnosed of vocal nodules, where we analyzed four stroboscopic parameters (glottal closure, vocal fold vibration, mucosal wave and phase symmetry) by a protocol based on systematic subjective evaluation of the stroboscopic images before and after the rehabilitator vocal treatment; and the results were stratified according to the clinical course. Results: All patients, before the treatment, had some abnormality in at least one of the four analyzed aspects. After the vocal treatment, we found improvement of the four parameters in different degrees. Also, we found a statistically significant relationship between the evolution of each parameter and the clinical course. Conclusion: We believe that the laryngostroboscopy, systematized through a protocol, is a useful technique for the diagnosis of structural abnormalities in patients with vocal nodules and is a useful technique for evaluating the results after the rehabilitator treatment, as there is a statistically significant relationship between clinical course and the change in the stroboscopic findings. However it should not be the only technique used for these proposes.
4.) Akif Kiliç, M., Okur, E., Yildirim, I., & Güzelsoy, S. (2004). The prevalence of vocal fold nodules in school age children. International Journal Of Pediatric Otorhinolaryngology, 68(4), 409. doi:10.1016/j.ijporl.2003.11.005
<B>Objective:</B> To explore the actual prevalence of vocal nodules among school age children. <B>Methods:</B> A total of 617 children aged from 7 to 16 years were examined. Their voices were recorded and analyzed by using acoustic analysis techniques, and vocal folds were examined by using rigid telescopic laryngoscope. The findings were noted as normal, minimal lesion, immature and mature nodules. <B>Results:</B> Laryngoscopic examination revealed that 430 (69.7%) of the children were normal. Of the remaining 187 children, 82 (13.3%) had minimal lesion, 88 (14.3%) immature nodule, 16 (2.6%) mature nodule and 1 (0.2%) vocal polyp. Comparisons of acoustic parameters revealed that there were no statistically significant differences between normal and minimal lesion groups, and between immature and mature nodule groups. Actual vocal nodule ratios which include both immature and mature nodule groups among whole school children were found to be 21.6% in males and 11.7% in females.
Background and Aim: Vocal cord nodule is one of the voice disorders causes hoarseness and breathy voice. Voice therapy is one of the treatment approaches. We aimed to find out the effects of voice therapy on vocal acoustic characteristics in these patients. Methods: In this case series, five women with vocal nodule (14 to 45-year-old) participated in a 9- week voice therapy program developed by Boone. Vocal hygiene and voice practices were measured every day using a questionnaire. Moreover, structure and movements of vocal folds were examined using videolaryngostroboscope by a laryngologist before and after voice therapy to evaluate the effectiveness of program. For collecting voice samples we used sustained /æ/ in comfortable loudness for all patients and data were analyzed using Speech Studio. Results: After voice therapy, fundamental frequency in four of five subjects were decreased but it was not significant (p=0.225). However, jitter in all of five subjects was significantly decreased (p=0.043). After voicetherapy, shimmer in three of five subjects were decreased that was not significant (p=0.345). Conclusion: Voice therapy can be used for the remedy of acoustic vocalcharacteristics and elimination or contraction of vocal cord nodule.
2.) Tezcaner, C., Ozgursoy, S., Sati, I.,& Dursun, G. (2009). Changes after voice therapy in objective and
subjective voice measurements of pediatric patients with vocal nodules. European Archives Of Oto-Rhino-Laryngology, 266(12), 1923-1927.doi:10.1007/s00405-009-1008-6
The aim of this study was to analyze the efficiency of the voice therapy in children with vocal nodules by using the acoustic analysis and subjective assessment. Thirty-nine patients with vocal fold nodules, aged between 7 and 14, were included in the study. Each subject had voice therapy led by an experienced voice therapist once a week. All diagnostic and follow-up workouts were performed before the voice therapy and after the third or the sixth month. Transoral and/or transnasal videostroboscopic examination and acoustic analysis were achieved using multi-dimensional voice program (MDVP) and subjective analysis with GRBAS scale. As for the perceptual assessment, the difference was significant for four parameters out of five. A significant improvement was found in the acoustic analysis parameters of jitter, shimmer, and noise-to-harmonic ratio. The voice therapy which was planned according to patients’ needs, age, compliance and response to therapy had positive effects on pediatric patients with vocal nodules. Acoustic analysis and GRBAS may be used successfully in the follow-up of pediatric vocal nodule
treatment.
3.) Halawa, W., García, A., & Pérez, S. (2013). Effectiveness of laryngostroboscopy for monitoring the evolution of vocal nodules after rehabilitator treatment. Auris Nasus Larynx, 40(2), 204-206. doi:10.1016/j.anl.2012.06.004
Objective: The aim of this study is to evaluate the effectiveness of the laryngostroboscopy for monitoring the evolution of patients with vocal nodules before and after the logopedic vocal treatment. Methods: We performed a prospective observational study of 97 dysphonic patients diagnosed of vocal nodules, where we analyzed four stroboscopic parameters (glottal closure, vocal fold vibration, mucosal wave and phase symmetry) by a protocol based on systematic subjective evaluation of the stroboscopic images before and after the rehabilitator vocal treatment; and the results were stratified according to the clinical course. Results: All patients, before the treatment, had some abnormality in at least one of the four analyzed aspects. After the vocal treatment, we found improvement of the four parameters in different degrees. Also, we found a statistically significant relationship between the evolution of each parameter and the clinical course. Conclusion: We believe that the laryngostroboscopy, systematized through a protocol, is a useful technique for the diagnosis of structural abnormalities in patients with vocal nodules and is a useful technique for evaluating the results after the rehabilitator treatment, as there is a statistically significant relationship between clinical course and the change in the stroboscopic findings. However it should not be the only technique used for these proposes.
4.) Akif Kiliç, M., Okur, E., Yildirim, I., & Güzelsoy, S. (2004). The prevalence of vocal fold nodules in school age children. International Journal Of Pediatric Otorhinolaryngology, 68(4), 409. doi:10.1016/j.ijporl.2003.11.005
<B>Objective:</B> To explore the actual prevalence of vocal nodules among school age children. <B>Methods:</B> A total of 617 children aged from 7 to 16 years were examined. Their voices were recorded and analyzed by using acoustic analysis techniques, and vocal folds were examined by using rigid telescopic laryngoscope. The findings were noted as normal, minimal lesion, immature and mature nodules. <B>Results:</B> Laryngoscopic examination revealed that 430 (69.7%) of the children were normal. Of the remaining 187 children, 82 (13.3%) had minimal lesion, 88 (14.3%) immature nodule, 16 (2.6%) mature nodule and 1 (0.2%) vocal polyp. Comparisons of acoustic parameters revealed that there were no statistically significant differences between normal and minimal lesion groups, and between immature and mature nodule groups. Actual vocal nodule ratios which include both immature and mature nodule groups among whole school children were found to be 21.6% in males and 11.7% in females.