Delivery of Intensive Voice Therapy for Vocal Fold Nodules Via Telepractice: A Pilot Feasibility and Efficacy Study

Objectives: This pilot study examined voice outcomes and patient perceptions after intensive voice therapy for vocal fold nodules via telepractice.

Study Design: Pilot, within-subjects experimental trial.

Methods: Participants included 10 women diagnosed with bilateral vocal fold nodules who received intensive voice treatment via a free videoconferencing platform Skype, (Microsoft Corp., Redmond, WA). All participants completed one vocal hygiene session in person, followed by eight sessions of therapy via telepractice over 3 weeks. Before and immediately after treatment, patients attended a clinic in person to complete perceptual, stroboscopic, acoustic, and physiological assessments of vocal function. Analyses were performed by a speech-language pathologist and an otolaryngologist independent to and blinded to the study. Participants also completed the Voice Handicap Index and a telepractice satisfaction questionnaire, or an anticipated satisfaction questionnaire, before and after the treatment.

Results: Significant improvements were found in perceptual, vocal fold function, acoustic, and physiological parameters as well as nodule sizes and patient perceptions of voice-related quality of life post-treatment. Participants were highly positive about their first experience with telepractice. Results were similar to those from a separate study investigating the effects of an intensive voice therapy delivered in conventional face-to-face (FTF) format.

Conclusions: This study is consistent with possible benefits of telepractice in the delivery of intensive treatment for vocal fold nodules. Pending final verification with a FTF comparison group, telepractice could be recommended as an alternate treatment modality for patients with vocal fold nodules.