EVALUATION OF THE ROLE OF THE ACCENT METHOD OF VOICE THERAPY AFTER MICROLARYNGEAL PHONOSURGERY

Document Type : Original Article

Authors

1 Unit of Phoniatrics, Faculty of Medicine, Ain-Shams University.

2 Unit of Phoniatrics, Medical Military Academy.

Abstract

Background: The accent method (AM) is one of the holistic approaches for behavior readjustment technique (BRAT). Anatomic physiologic explanation for the accent method is the rhythmic pairing of timing with respiration and phonation may promote motor learning of new phonatory behaviors that will enhance the Bernoulli's effect to restore the glottic wave with better adjustment and symmetry of the vibrator (vocal fold mucosa). Aim of the work: To evaluate the role of applying the accent method of voice therapy on patients with different benign vocal fold lesions post-operatively in order to emphasize the importance of postoperative Accent Method in improving the vocal performance. Patients and Methods: This study was conducted on 100 patients: 50 adult patients of both sexes received "accent exercises" of voice therapy 1week after microlaryngeal phonosurgery which was the study group (G1) and other 50 adult patients of both sexes as a
control group (G2) received only voice hygienic advice. Three assessments were done, the first was before the microlaryngeal phonosurgery, the second was one week after surgery and the third was after the course of the voice therapy which compared subjective and objective voice evaluation parameters investigating the therapeutic effect of voice therapy. Results: For the second assessment (after microlaryngeal phonosurgery), there were no statistically significant differences between the 2 groups in all voice evaluation parameters. For the third assessment (after the "accent exercises" given to G1 only and voice hygienic advice given to both groups), there were statistically significant/highly significant differences in favor of G1 as regard auditory perceptual assessment (APA), high-speed video-kymography
parameters, acoustic analysis and aerodynamic measures. Conclusion: Since the minimal associated pathological lesions
(MAPLs) represent 10% of dysphonia in vocology which likely a result of phonotrauma (abuse and misuse of voice), voice therapy after doing microlaryngeal phonosurgery is almost always a good idea in order to make the person aware of circumstances and habits of voice use that may lead to recurrence of the lesion in the first place.

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