Voice therapy strategies for spasmodic voice disorder

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Treatment of sposmodic voice disorder (SPD) has been known as most difficult among various kinds of voice disorders. Voice therapy is not very popular in Japan and no speech therapist has worked with SPD patients even if it has been well known in the US that voice therapy is effective for mild to moderate SPD patients. Since 1994 we have tried various kinds of voice therapy techniques for some SPD patients and we obtained good results for most cases. In this study, based on the past results, several voice therapy techniques were selected and applied to 10 SPD patients to find out the effectiveness of voice therapy and the most effective voice therapy strategy. Voice evaluation using auditory impression and visual inspection of the larynges revealed remarkable voice improvement after voice therapy in all patients. Breathy phonation was used for all patients and was found to be very effective. For moderate to severe cases, some therapy techniques had to be used in combination with others to improve vocal syndromes. Slow speech rate seemed very effective for reducing excessive laryngeal tension and was used for many cases in combination with other relaxation techniques. Acoustic analyses also revealed disappearance of vocal spasmodicity (inconsistent voice quality and intensity). Effectiveness of voice therapy was proven in this study bad on qualitative data. Future study is desperately needed to confirm the results with quantitative data.