Efficacy of a Semi-occluded Mask in the Treatment of Patients With Voice Disorders
Condition: Voice and Resonance Disorders; Vocal Fold Polyp; Vocal Cord Cyst; Vocal Cord Polyp; Atrophy of Vocal Cord
MeSH terms: Voice Disorders; Atrophy; Polyps
Study type: Interventional

Summary: 
      Current semi-occluded vocal tract therapies limit the type of vocalizations that can be
      produced to single vowels, which does not promote learning of the healthy voice behavior in
      connected speech or generalization to conversation. However, recent preliminary results using
      a semi-occluded mask indicate that the use of certain mask port diameters may allow for
      natural speech production while increasing supraglottal pressure and impedance, and thereby
      result in elicitation of voice with increased efficiency. In addition, the use of a
      semi-occluded mask provides the possibility for a better transition from phonating single
      phonemes in therapy to training the target therapy techniques in connected speech.
    

Detailed description: 
      Treatment of voice disorders varies but often involves voice therapy and/or surgical
      intervention. Voice therapy, a non-invasive behavioral treatment for voice disorders, helps
      patients develop beneficial voice habits, prevents recurrence of voice disorders, and
      facilitates long-lasting vocal improvement. Many voice therapy techniques involve a
      semi-occluded vocal tract (SOVT). SOVT treatment is often characterized by sustained (straw
      phonation, voiced fricatives, nasals), oral oscillatory (lip buzzes, tongue trills,
      raspberries) or transitory phonation (plosives and glides). Straw phonation therapy, one of
      the most utilized SOVT methods, was first proposed in 1904 and involved phonating at
      different pitches into small glass tubes with varying diameters and lengths providing
      simultaneous semi-occlusion and extension of the vocal tract. Voice therapy exercises
      involving voice production with a semi-occluded and sometimes lengthened vocal tract have
      demonstrated improved vocal efficiency and loudness, reduced mechanical trauma to the vocal
      fold mucosa, and improved source-filter interaction.Our group recently developed a
      semi-occluded facemask for use in patients with and without voice disorders. Recent
      preliminary results using this semi-occluded facemask indicated that the use of a certain
      mask port diameters may elicit voice with increased efficiency. A study of 5 participants
      without voice disorders revealed that a mask occlusion diameter of 6.4 and 3.2 mm resulted in
      improved vocal efficiency. A study of the immediate effects of a semi-occluded facemask in 20
      patients with voice disorders revealed that occlusions diameters of 9.6, 6.4, and 3.2 mm all
      resulted in significant improvements in acoustic and aerodynamic voice outcomes.
    

Intervention name(s): Inclusion of semi-occluded mask in voice therapy
Intervention type(s): Device
Intervention description(s): Patients will be given a facemask with a semi-occlusion (SOMask) for use during in person voice therapy and for use at home therapy practice.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: SOVT; semi occluded vocal tract; voice disorder; voice therapy; muscle tension dysphonia; MTD; vocal fold lesions; vocal fold atrophy