Combination of Manual Laryngeal Therapy and changes in sound notes in the recovery of the voice of 3 patients with Sulcus Vocalis

Background and Objectives:Sulcus vocalis is described as a groove at the free edge of the vocal fold. Different types have been described: sulcus type I is superficial and may be considered as moreless physiologic. Sulcus type IIa corresponds to a kind of vergeture along the margin of the vocal fold. Its deepness is variable but sulcus vergeture may involve deeper layers of the lamina propria. Sulcus type IIb or pounch may be considered as an open cyst. Sulcus lead to a complex glottic dysfunction with, in the same time, a glottal leakage responsible for the breathy component of the dysphonia and a stiffness of the free edge responsible for the roughness.The usual method for treating such patients is surgery, which is usually at high risk and unsuccessful. Of course, speech therapies have not been studied yet .Our aim in this study was to investigate the effect of manual therapy with variations of sound notes to improve the sound of patients with Sulcus vocalis type 1 and 2.Study Type: Pre and Post Intervention(quasi experimental) Materials and Methods:In this study, three patients with congenital Sulcus vocalis were studied. These patients were evaluated using parameters of Jitter, Shimmer and HNR. For these patients, manual therapy was used to train patients to develop the ability to raise and lowering voluntary larynx to reduce and enhance the length of the acoustic tube and the Increase and reduce stretchingthe vocal cords. Combined with this method, educating patients by teaching different note styles using piano keyboard on Android phones.Results: After the training of patients, there were significant changes in the voice of the patients in order to produce sound with different pitches. Originally, with the training of these patients, the vocal cords habitually contact area moved to produce a new voice, and the stretching and length of the vocal cords are adjusted according to the quality of the sound. The average jitter variations from 0.94 ± 0.48 receipts to0.54 ± 0.56 and the shimmer from 5.53 ± 2.32changed to3.37 ± 1.27 and HNR from 15.14 ± 4.11 to 20.17 ± 7.19 acquired. These changes indicate improvements in the most important sound quality parameters.Conclusion: The results were just anintroduction to a comprehensive study of the efficacy and therapeutic effects of manual laryngeal therapies. Creativity in the combination of different treatments for larynx and voice therapies can be a way to show the capabilities of a voice therapist..

Keywords:

Manual laryngeal Therapy , Sulcus Vocalis , Acoustic Parameters