A comparative study between the use of Resonance Tube Voice Therapy and Smith-Accent Voice Therapy in rehabilitation of hyperfunctional dysphonia

Abstract

Voice is the complex, dynamic product of vocal fold vibration that allows us to vocalize (i.e. make sound) and verbalize (i.e. produce language through speech) (Justice, 2006). The basic task of the voice is to act as a carrier wave of verbal communication (Vilkman, 2000). Control of voice is an essential component in the individual’s ability to adjust the social situation, to make good contact and maintain equilibrium in relation to the audience. Voice disorders are characterized by abnormalities in pitch, loudness, and/or quality of the voice that can limit the effectiveness of oral communication. In order to produce a normal voice, the laryngeal function must be coordinated, efficient and physiologically stable. Any imbalance in this delicate system affects vocal quality. When the vocal quality deteriorates and both anatomical and neurological etiologic factors are excluded, a functional voice disorder should be suspected. Functional voice disorders account for at least 40% of the cases of dysphonia referred to multidisciplinary voice clinics. They occur predominantly in women (Werning et al., 2007). The prevalence of voice disorders among teaching staff was 57%. The most prevalent lesions were phonasthenia “vocal overstrain” (18%), nodular lesions (14%), and hyperfunctional dysphonia (8%). The incidence rate was 3.87 new cases per year per 1000 teachers. Women had organic lesions three times more than men. However, men had chronic laryngitis three times more than women and functional dysphonia nearly twice more than women. There was significant risk of suffering voice disorders in teachers who smoke daily and who drink several cups of coffee or tea. It is advisable to carry out an annual evaluation of all teaching staff on account of the high prevalence of voice disorders among them (Julián et al., 2008). The process of voice therapy provides a variety of therapeutic techniques that can teach individuals to develop voice habits that will preserve a resonant and healthy voice. These techniques may include vocal hygiene and voice conservation as hydration, yawn sigh, and voice relaxation to wear away any defects in the larynx that may be causing a voice disorder (Theiss, 2010). In order to completely benefit from the process of voice therapy to prevent voice disorders in the future, it is crucial that an individual practices the therapeutic techniques that voice therapy advises regularly (Phillips, 2012). According to Sharma et al. (2016), the most commonly used therapy techniques are Smith Accent Method and Resonance Tube Therapy. The Smith Accent method of voice therapy uses rhythmic exercises to facilitate the coordination of minimally-constricted vocal fold vibration with appropriate air pressure and air flow. The SA method is a holistic approach that addresses pitch, loudness and timbre simultaneously, rather than focusing separately upon each of these vocal parameters (Sharma et al., 2016).