Non-Medical Treatments of Vocal Fold Nodules: A Systematic Review

Introduction: Voice therapy and laryngeal microsurgery are the treatment options for treating vocal fold nodules (VFNs). The risks of general anesthesia and scar formation are the side effects of surgery in the treatment of VFNs. So, the first-line recommended treatment strategy for VFNs is conservative management approaches. To most authors, among these options, voice therapy is the primary treatment and surgery is recommended only when voice therapy is not helpful in the management of VFNs. There are many approaches for treating VFNs in voice therapy, including vocal hygiene and patients’ education, relaxation exercises, direct facilitation, respiratory exercises, and so on. Meanwhile, there is a lack of a thorough review of the literature on the therapy approaches used for treating VFNs.The aim of the present systematic review was to investigate the nonmedical treatments of vocal fold nodules.Methods: The following electronic databases were searched from inception until August 2016: PubMed, Scopus, ScienceDirect, Ovid, ISI (Web of Sciences), Cochrane, PsychINFO, the Cochrane Central Register of Controlled Trials, and Google Scholar. Reference lists of included articles were evaluated for additional data. Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to carry out and report the review. The methodological quality of the articles included was evaluated using the Physiotherapy Evidence Database scale. Due to the heterogeneity of the studies, a narrative synthesis of the evidence was performed to summarize the evidence.Results: Out of 2,099 records identified, 21 articles met the inclusion criteria and thus were included in the review. The studies investigated in the present review were different in terms of study design, participant characteristics, types of assessments and treatments, and treatment delivery. However, nonmedical treatments of VFNs were found to be successful in improving vocal quality, decreasing VFN sizes, and resolving these nodules.Conclusions: The results of the present review could provide primary evidence related to the effectiveness of nonmedical treatment of VFNs. Yet further studies with a high level of evidence, a rigorous methodological quality, and long-term follow-up evaluations are required to make stronger claims.

کلیدواژه ها:

Vocal fold nodules ، Treatment ، Non-medical