A vocal treatment plan for voice disorders after phonosurgery--a preliminary study

In this study, twenty-five subjects have received phonosurgery of benign vocal pathology but persistent voice disorders postoperatively, characterized by a hoarse, low-pitched, soft voice or efforted phonation. Each subject had filled out a self-evaluation questionnaire of vocal behaviors before surgery and his vocal cords examined by ENT doctor with indirect laryngoscope or direct fiberscope. Voice evaluations was done based on perceptual and acoustic parameters preoperatively and postoperatively. Twenty-five subjects were grouped into three post-operative vocal rehabilitation programs: voice rest group, vocal hygiene group, and direct voice therapy group. The criteria in grouping were according to the subjects' amount of vocal use, environmental pressures, vocal abuse or misuse behaviors and time flexibility. The therapy strategies included reducing amount of vocal use, changing life style, analyzing environmental pressures and treating voice problems with established facilitating techniques. The post-surgical vocal rehabilitation program lasted three to six months. Each subject's voice parameters were reevaluated six months after surgery. The results of three vocal rehabilitation groups were compared with those before rehabilitation. The implication of this study is to provide a holistic voice treatment plan and obtain better surgical intervention results.