The effects of Cricothyroid Visor Maneuver (CVM) therapy on the voice characteristics of patients with muscular tension dysphonia: A Case Series Study



      The purpose of this study was to assess the effects of a novel manual therapy, the Cricothyroid visor maneuver (CVM) therapy, on acoustic, auditory perceptual and self-assessment ratings in Muscle tension dysphonia (MTD) patients.

      Study design

      This was a retrospective study of 6 clinical cases.

      Materials and Method

      The study comprised 6 Persian speakers with MTD (2 men and 4 women) and mean age 38.50 ± 5.32 years. All patients underwent therapy between April and June 2021. Therapy was provided in five 30-minute sessions. This study used of acoustic measurement including smoothed cepstral peak prominence (CPPs), Dysphonia Severity Index (DSI), self-assessment scales include vocal tract discomfort scale (VTD), voice related quality of life (V-RQOL) and Consensus Auditory- Perceptual Evaluation of Voice (CAPE-V) for auditory perceptual assessment in pre- and post-CVM sessions.


      In the present study the CPPs and DSI increased while only CPPs significantly changed in pre and post therapy (P < 0.05). Also, having done the therapy the total severity of dysphonia (CAPE-V) and VTD significantly decreased (P < 0.05) and V-RQOL significantly increased (P < 0.05).


      These results suggest that CVM can be an effective method for promote significant improvements in acoustic measurements, auditory perceptual and self-assessment scales in patients with MTD.

      Key Words


      MTD (Muscle tension dysphonia), CVM (Cricothyroid visor maneuver), MCT (manual circumlaryngeal therapy), LMT (laryngeal manual therapy), VFTs (vocal facilitating techniques), CPPs (smoothed cepstral peak prominence), DSI (Dysphonia Severity Index), CAPE-V (Consensus Auditory-perceptual Evaluation of Voice), VTD (vocal tract discomfort scale), V-RQOL (voice related quality of life), MPT (maximum phonation time)
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