J Korean Soc Laryngol Phoniatr Logoped.  2020 Jun;31(1):13-18. 10.22469/jkslp.2020.31.1.13.

Effect of Voice Reinforcement Method for Treatment of Vocal Nodules: Preliminary Study

  • 1Department of Otorhinolaryngology, Chungbuk National University Hospital, Cheongju, Korea
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Cheongju, Korea


and Objective The purpose of this study is to report the effect of voice therapy using the voice reinforcement method (VRM) in patients with vocal nodules. It is one of the holistic voice therapy methods for improving vocal mechanisms. VRM includes not only direct and indirect voice therapy, but also trial therapy and self-practice. Composed of four stages: vocal hygiene education, relaxation, reinforcement, and generalization.

Materials and Methods
The subjects were 13 patients who were diagnosed with vocal nodules. Acoustic analysis, auditory perceptual assessment, K-VHI-10 and nodules size were compared before and after voice therapy. Voice therapy was conducted by speech-language pathologist and the mean number was 4.2.

In acoustic analysis, Jitter, vF0, vAm, Shimmer, NHR, and VTI were significantly decreased. F0 was increased after voice therapy for women. ‘Grade’, ‘Rough,’ and ‘Breathy’ were significantly decreased in the GRBAS scale after voice therapy. In addition, K-VHI-10 and nodules size were significantly decreased.

VRM seems to be an effective voice therapy method in vocal nodules treatment. In VRM, especially, trial therapy is given motivation for vocal nodules treatments and self-practice has a continuous therapeutic effect in everyday life. VRM can be also applied to the voice therapy for other hyper-functional dysphonia.


Vocal nodules; Voice therapy; Semi-occluded vocal tract exercise; 성대결절; 음성치료; 반폐쇄성도운동
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