Usefulness of Voice Therapy on Vocal Nodules in Professional Voice Users Treated with Steroid Injection

Lee, Jung Yup; Lee, Jae Hyuk; Choi, Jeong Im; Lee, Sang Hyuk; Jin, Sung Min

Abstract

BACKGROUND AND OBJECTIVES
A local steroid injected directly into the vocal nodules has recently come to the forefront as another treatment option, which is reported as useful and effective. However, vocal nodules are caused mainly by excessive voice use, and therefore, even if a marked improvement was shown after injection, recurrence can occur unless the voice abuse habit is changed. We hypothesized that voice therapy after steroid injection would reduce recurrence of vocal nodules in professional voice users.
SUBJECTS AND METHOD
This prospective study included thirty female professional voice users with vocal nodules treated with vocal cord steroid injection on between May 2010 and March 2011. The experimental group (n=15) received the voice therapy after vocal cord steroid injection, and the control group (n=15) received only vocal cord steroid injection. Videostroboscopy, acoustic voice analysis, and Voice Handicap Index (VHI) were evaluated prior to the steroid injection and 4 and 8 weeks after steroid injection.
RESULTS
Jitter, shimmer, noise-to-harmonics ratio, and mean VHI improved significantly after steroid injection in both group (p<0.05). There was no significant complication and voice discomfort after steroid injection in both groups. And, there were no significant differences in all parameters between the two groups. However, the experimental group (13.3%) showed less recurrence rate of vocal nodules than the control group (53.3%) after 8 weeks.
CONCLUSION
Vocal cord steroid injection was useful treatment option of vocal nodules in professional voice users. And voice therapy after steroid injection would be effective in preventing a recurrence of vocal nodules than only steroid injection.