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Abstract

Introduction: The association of speech therapy (ST) with phonosurgery can improve vocal quality. Preoperative ST enhances treatment adherence and addresses factors contributing to vocal fold injury. Postoperative ST promotes healing and helps manage potential compensatory muscle tension.
Methods: Development of an intervention protocol between Otorhinolaryngology (ORL) and ST in the pre and postoperative management of phonotraumatic laryngeal pathology, based on a literature review and the experience of a Tertiary Hospital.
Results: The ORL assessment includes clinical history and audioperceptive evaluation - pitch, loudness and GRBAS (Grade/Roughness/Breathiness/Asthenia/Strain) scale. Objective examination is complemented by videostroboscopy, assessing vocal fold vibration, mucosal wave propagation, and the presence of lesions or signs of supraglottic hyperfunction. In the preoperative ST consultation, the impact of dysphonia is assessed using the Voice Handicap Index-10; aerodynamic assessment - maximum phonation time and S/Z ratio - and acoustic analysis - fundamental frequency, jitter, shimmer, and harmonics-to-noise ratio - are also obtained. Patients receive vocal hygiene recommendations, semi-occluded vocal tract and relaxation exercises, and guidance on appropriate breathing techniques. Postoperatively, 3-5 days of voice rest are recommended, and patients are reassessed by ORL and ST. ORL repeats the audioperceptive assessment and videostroboscopy to assess healing. ST follow-up includes reinforcement of vocal hygiene recommendations, posture control exercises, postural and vibratory relaxation techniques, costodiaphragmatic breathing, and coordination of respiration and phonation. Conclusion: This protocol underscores the importance of coordinated ORL and ST intervention in the pre and postoperative periods to optimize surgical outcomes in patients with phonotraumatic laryngeal pathology.