Summary
Objectives
Functional dysphonia (FD) varies in terms of vocal behavior and treatment efficacy.
So-called hypofunctional dysphonia is characterized by insufficient subglottal pressure
which causes a lack of driving power needed to vibrate the vocal folds leading to
weak voice or aphonia in severe cases. While voice therapy is the initial treatment,
some patients fail to respond to it. Interferential current (IFC) stimulation has
been used as part of rehabilitation by physical therapists to reduce the progressive
pain. IFC stimulation has also been developed as a laryngeal sensory stimulation device
to modify the swallowing function by triggering swallowing reflex. Many researchers
have shown recently in animal studies that laryngeal afferent inputs, such as vocal
fold vibrations, subglottic pressure, flow rate, and vocal fold location affect vocal
motor pattern and voice quality. However, IFC stimulation as a laryngeal afferent
has not been verified. Herein, we assessed the effects of IFC stimulation to the neck
on difficult functional dysphonia.
Methods
Six patients with refractory FD with insufficient subglottic pressure were assessed
in this study. All six cases were females and two of them presented with aphonia.
All cases were initially treated by voice therapy (VTx) such as flow phonation, water
resistance therapy, or tube phonation for 2 months to increase subglottic pressure;
however, this resulted in poor improvement in voice.
We additionally performed VTx with concurrent application of IFC stimulation to the
neck for 3 months, and the effects on voice were evaluated.
Results
VTx with IFC stimulation resulted in improved voice in all cases, demonstrating the
improvement in maximum phonation time, subglottic pressure, and voice handicap index-10.
Conclusions
Results from this clinical study suggest that VTx with IFC stimulation may be useful
for adjusting vocal function in patients with FD caused by insufficient subglottic
pressure.
Key Words
Abbreviations:
IFC (interferential current), VHI-10 (voice handicap index-10), CPG (central pattern generator), FD (functional dysphonia), SLN (superior laryngeal nerve), RLN (recurrent laryngeal nerve), MPT (maximum phonation time), NTS (nucleus tractus solitarius), RF (reticular formation), VTx (voice therapy)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 16, 2023
Accepted:
December 27,
2022
Publication stage
In Press Corrected ProofFootnotes
Presented at the Voice Foundation's 51st Annual Symposium, Philadelphia, Pennsylvania, U.S.A., June 1– 5, 2022.
No financial disclosures.
Identification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
