Voice Therapy May Help Treat Vocal Fold Polyps and Cysts

Despite this lack of evidence, Dr. Sulica thinks that voice therapy is probably appropriate for nodules, polyps, and cysts.

Advantages of Voice Therapy

One of the main advantages of voice therapy is that it may allow some patients to forgo surgery, and for patients who cannot undergo surgery, it provides an alternative option. If a patient is too ill to undergo surgery or does not want surgery, said Dr. Woodson, voice therapy is an alternative that might improve the voice.

Seth Cohen, MD, MPH

Voice therapy may also be a good alternative for patients who cannot commit to surgery and the postoperative rehabilitation period that often requires resting the voice. Voice therapy can bring benefit for some patients who cannot miss work and otherwise commit to the surgery and rehab process, said Dr. Cohen, adding that voice therapy can also provide some voice improvement until more definitive treatment can be undertaken by the patient.

According to Dr. Sulica, avoiding surgery if possible is a responsibility of clinicians. I’d suggest that part of being a good laryngologist involves avoiding all avoidable surgery, he said, adding that physicians may be reluctant to use voice therapy out of some misguided sense that they’re going to ‘lose the case.’

Another reason may be the lack of skilled voice therapists. According to Dr. Sulica, the most common comment by otolaryngologists in the 2003 survey was the lack of skilled voice therapists in their area. All voice therapy is not the same, said Dr. Sulica. Just sending a patient along to a speech-language pathologist doesn’t ensure that he or she is going to get appropriate therapy. A skilled voice therapist is a speech-language pathologist who has gone out of his or her way to develop an expertise in voice disorders.

Further Research Is Required

Although voice therapy is now commonly used for vocal fold nodules, its use for vocal fold polyps and cysts is less defined. New evidence suggests that many patients-particularly those with translucent polyps-may benefit from voice therapy for these lesions. Although surgery remains the treatment of choice for these lesions, voice therapy may be a good alternative for patients in whom surgery is contraindicated or for whom it carries too much of a burden. Further studies are needed to prospectively validate these preliminary data, and to address unanswered questions such as the longevity of voice improvement with voice therapy for these lesions.