Wednesday, 7 March 2018

A Simple Voice Training Method by Emphasizing Abdominal Respiration and Refractory Laryngeal Granulomas

It has been suggested that doctors should perform voice therapy in cooperation with speech therapists. However, speech therapists have not fully spread in Japan. Therefore, we designed “a simple method of voice training by emphasizing the importance of abdominal respiration” and relying on only a single doctor to administer this voice training. Voice therapy is the first choice for vocal fold nodules in Japan. Previously, we reported the improvement of 9 cases with vocal fold nodules using this method.

Some hospitals reported high rates of postoperative recurrence, therefore, proton pump inhibitor (PPI ) treatment have been the first choice for laryngeal granulomas. However, some cases do not improve by PPI alone. In this study, our voice training was employed for refractory laryngeal granuloma cases that were resistant to PPI (including postoperative recurrent cases ). In Japan, evaluation of the effectiveness of voice therapy is widely done using the grade rough breathy asthenic strained scale (GRBAS scale). The GRBAS scale is considered the gold standard for psychoacoustic voice evaluation in Japan, and is a subjective rather than objective evaluation. Therefore, we tried to make our evaluation as objective and clear as possible. The grade of the effectiveness of our training was evaluated by changing the laryngeal diseases.

At our hospital otorhinolaryngology out-patient clinic, voice therapy was performed from April 2011 to June 2017 using the simple method of voice training by stressing the importance of using abdominal respiration. All patients (29) received an explanation about surgical and pharmacological treatments, as well as our voice training method, and chose our method of voice training. Finally, All 29 cases with laryngeal granulomas had not improved by PPI treatment for 8 weeks. Four cases with postoperative recurrence did not improve by PPI treatment. All cases were treated by our method of voice training alone, using no other therapy (e.g., silent therapy, medicine, operation) during the voice training period. 

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