Voice Therapy Research Articles

Blue light laser recontouring for pediatric benign fibrovascular vocal fold lesions

Up to 40% of children with hoarseness due to benign fibrovascular vocal fold lesions do not respond to voice therapy and could benefit from further intervention to improve their communication abilities. Currently there are limited surgical options for children too young to comply with post-operative voice rest. We have begun using the 445 nm laser to recontour benign fibrovascular vocal fold lesions without post-operative voice rest in young children with hoarseness due to vocal fold nodules that is unresponsive to voice therapy. This report presents pilot data on the effect of this treatment on pediatric voice-related quality of life.Pediatric patients with benign fibrovascular lesions and severe subjective dysphonia (per parents or teachers) were given the option of undergoing surgery or continuing voice therapy. Those that opted for surgery underwent 445 nm laser recontouring of their vocal folds. They were discharged home the same day with no voice rest required. Pre- and post-demographic, acoustic measures, auditory perceptual assessments, and validated patient quality of life measures were collected.Four patients (ages 3-8y, all male) were selected for surgery. The mean pre- and post-op PVRQOL scores were 59.4 (range: 22.5-80) and 98.1 (range: 97.5-100), respectively (low scores suggest lower voice-related QOL), and a mean change of 38.8 (previously established minimum clinically important difference: 12). Pre- and post-acoustic and aerodynamic measures similarly reflected this improvement.This pilot case series addresses a commonly seen population (children with benign fibrovascular lesions and significant dysphonia despite voice therapy) where the best practice for timing and types of surgical intervention is unclear. Photoangiolytic lasers (including the 445 nm laser) are gaining popularity for the treatment of benign laryngeal pathologies, and their use may expand treatment possibilities for children with severe dysphonia due to benign vocal fold lesions that do not respond to voice therapy. Further longitudinal investigations are necessary to confirm the safety and efficacy.

Comparison and Relation Between Vocal Tract Discomfort and Voice Handicap Index in Teachers With and Without Muscle Tension Dysphonia

Objective One of the most voice-related complaints in teachers is vocal tract discomfort (VTD) which can increase the voice handicap index (VHI) to different degrees. In teachers Muscle Tension Dysphonia (MTD), increases voice complaints and decreases the voice-related quality of life. The aims of this study were to evaluate and compare the frequency and severity subscales of the VTD score and total score of VHI and determine the relation between them in primary school teachers with and without MTD. Materials & Methods This study was cross-sectional and was performed on 80 primary female teachers with and without MTD. The participants in both groups were randomly selected after checking the inclusion criteria. Voice history, auditory-perceptual assessment of voice, palpation, and laryngeal video-stroboscopy were assessed on the teachers in two groups. Then, asked the participants to complete the Persian versions of the VTD and VHI scales. After determining the normal distribution of the data using the Kolmogorov-Smirnov test, the results of VTD, VHI, and their subscales were compared between two groups with an independent t-test. Also, the relationship between them was assessed with the Pearson correlation coefficient analysis. Results The mean score of the frequency subscale of VTD in teachers with MTD was more than in teachers without MTD (30.17±5.11, 8.22±2.26), respectively. The score of severity subscales of VTD in teachers with MTD was 39.12±4.94 and in teachers without MTD was 7.89±2.13. Also, the total score of the VHI questionnaire in teachers with MTD was significantly higher than teachers without MTD (P<0.05). Moreover, there was a significant positive correlation between the frequency and severity subscales of VTD and the total score of VHI in the two groups (P<0.05). Conclusion This study showed the frequency and severity scores of the VTD and the degree of VHI experienced by MTD are remarkably higher than teachers without MTD. The authors emphasize on the use of VTD and VHI scales in screening teachers who are at risk of voice problems, and the researchers pointed out the importance of paying attention to the reduction of discomfort feelings in the vocal tract and voice handicap in the voice therapy sessions of teachers with MTD.

(053) Multidisciplinary Treatment of Transgender Woman with Severe Gender Dysphoria and Comorbid Psychiatric Disorders - Case Report

Abstract Introduction Gender dysphoria is a distress a person feels due to incongruence between their gender identity and their birth assigned sex. Transgender people have higher rates of mood disorders, suicidal ideations and suicide attempts as well as poorer general health. They often abuse psychoactive substances. There is also a correlation between perceived stigma and discrimination. Objectives The purpose of this case report is to show the treatment process of a transgender person born as a man using multidisciplinary approach based on the bio-psycho-social model, taking sex history, comorbid psychiatric disorders, social constraints and psychological needs into account. Methods A 45-year old male came to the Transgender clinic in Ljubljana, Slovenia. He wanted to transition from male to female. At that time, his appearance, sex and gender was male. He was a miner, married to a woman and lived with his wife in the countryside. His family was ashamed of him because he would go on nights out in public dressed as a woman and had a drinking problem. In the diagnostic phase we confirmed alcohol dependency and severe depression and had him join the addiction treatment programme, which proved successful as he reached stable abstinence. Having overcoming alcohol addiction he still tried very hard to repress his desire to become a woman. His wife tried to get pregnant but he avoided sexual intercourse. He had serious problems with erection and painful sex ascribed to phimosis and eventually got circumcised. He also confessed that he still dressed as a woman in secret, that he wanted to become a woman and consequently started referring to himself as ‘a she’. The wife demanded a divorce. Clinical psychological assessment showed no psychiatric contraindications to start with hormone therapy, first with antiandrogens and a year later with oestrogens, which successfully reduced her gender dysphoria. She reached emotional stability and stopped taking antidepressants. She did not need any otorhinolaryngological procedures or voice therapy. She had face laser therapy and genital epilation as well as nose operation, breast augmentation and genital reconstructive surgery. She received support from the Slovenian non- government organisations and other transgender women. She got a permanent new job in the same firm. Her family of the origin finally accepted her. Results Treatment, which lasted for ten year, resulted in a complete medical and social transition without any regrets. She now lives as a woman, uses dilatators and wants to have a biological male partner. She is on permanent therapy with oestradiol, aldactone, dutasteride, and vitamin D. She does not drink alcohol, has no comorbid psychiatric disorders neither gender dysphoria. She is emotionally stable with positive body image and self-esteem. She wears a wig because of hair loss. Conclusions Treatment, which lasted for ten year, resulted in a complete medical and social transition without any regrets. She now lives as a woman, uses dilatators and wants to have a biological male partner. She is on permanent therapy with oestradiol, aldactone, dutasteride, and vitamin D. She does not drink alcohol, has no comorbid psychiatric disorders neither gender dysphoria. She is emotionally stable with positive body image and self-esteem. She wears a wig because of hair loss. Disclosure No.

The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta-analysis.

Muscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front-line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics-to-noise ratio) and vocal function (fundamental frequency) through a systematic review with meta-analysis. Four databases were searched from inception to December 2022, and a manual search was performed. The PRISMA extension statement for reporting systematic reviews incorporating a meta-analysis of health care interventions was applied, and a random effects model was used for the meta-analyses. We identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's d > 0.8). Significant improvements were obtained in jitter in percent (mean difference of -.58; 95% CI -1.00 to 0.16), shimmer in percent (mean difference of -5.66; 95% CI -8.16 to 3.17), and harmonics-to-noise ratio in dB (mean difference of 4.65; 95% CI 1.90-7.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered. The efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics-to-noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high-quality randomized control trials are needed to support evidence-based practice in laryngology. Laryngoscope, 134:18-26, 2024.

The efficiency of the DoctorVox voice therapy technique in conversion dysphonia and aphonia.

The main purpose of this study was to retrospectively evaluate the efficiency of DoctorVox voice therapy in psychogenic dysphonia or aphonia patients, and to share the mid- to long-term results of the method. The study was carried out on patients who underwent DoctorVox voice therapy for psychogenic dysphonia or aphonia between January 2015 and September 2019. The evaluation methods used were: the Voice Handicap Index-10; the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale; and videolaryngostroboscopy recordings. The mean Voice Handicap Index-10 values of the patients were 30.91 ± 2.97 before treatment, 8.14 ± 3.82 after treatment, and 3.36 ± 1.78 in the final follow-up examination. The grade, roughness, breathiness, asthenia and strain scale scores were: 9 ± 0.67 pre-treatment, 0.78 ± 0.80 post-treatment, and 0.57 ± 0.64 at the final follow up. DoctorVox voice therapy seems to be an efficient treatment method for psychogenic dysphonia or aphonia; it helps develop phonatory muscle functions, using multidimensional biofeedback mechanisms, and increases the patients' therapy adherence.

Introduction to the Perspectives Forum on the Topic of Meta-Therapy in Speech-Language Pathology

Introduction to the <i>Perspectives</i> Forum on the Topic of Meta-Therapy in Speech-Language Pathology

Beyond the Stuttering Toolbox: The Concept of Meta-Therapy

Purpose:The purpose of this clinical focus article is to describe how meta-therapy applies to stuttering treatment.Method:We briefly summarize the concept ofmeta-therapy, which was first introduced by Helou (2017) in the context of behavioral voice therapy. We then apply basic meta-therapy principles to stuttering, with the goal of helping novice clinicians leverage their clinical dialogue to improve effectiveness and efficiency in the treatment setting. Examples of effective clinical dialogues are presented within the basic goal-based structure of meta-therapy.Conclusion:The application of meta-therapy approaches in stuttering treatment should improve outcomes and increase efficiency.

Parents’ Perceptions of and Attitudes Toward Voice Therapy

PurposeThis study aimed to investigate Chinese parents’ perceptions of pediatric voice disorders to determine their level of health literacy and knowledge gaps to understand the determinants of initiating voice therapy for children with dysphonia. MethodA cross-sectional survey was conducted in three voice clinics in Chengdu, China, from October 1, 2021, to October 1, 2022. Impairment of children’s quality of life as perceived by parents was assessed using the pediatric Voice-Related Quality-of-Life (pVRQOL) scale. ResultsOverall, 206 parents whose children were recommended voice therapy were recruited (Mean ± SD age, 35.0 ± 4.62 years; male/female = 1:3). When otolaryngologists recommended that their children with dysphonia initiate voice therapy, most participants had positive responses (n = 176, 85.4%). The mean pVRQOL score was 40.8 in the accept group and 37.6 in the reject group (difference, 1.7; 95% CI, −4.98 1.69). Participants who had a more influential work status, had an only-child, had children with shorter-term voice symptoms, and visited specialized hospitals were more likely to have negative practices related to children’s voice therapy (P < 0.05). ConclusionsThis study represents an important first step in understanding Chinese parents' perceptions of and motivations for initiating voice therapy for their children with dysphonia. Initiation of treatment as recommended in pediatric populations depends on multiple factors, such as the duration of voice symptoms, family structure, and hospital type. It is imperative to promote public health care education on voice therapy among parents, as health care literacy is the primary driving factors in decision-making.

Exploring Motives and Perceived Barriers for Voice Modification: The Views of Transgender and Gender-Diverse Voice Clients.

To date, transgender and gender-diverse voice clients' perceptions and individual goals have been missing in discussions and research on gender-affirming voice therapy. Little is, therefore, known about the client's expectations of therapy outcomes and how these are met by treatments developed from views of vocal gender as perceived by cisgender persons. This study aimed to explore clients' individual motives and perceived barriers to undertaking gender-affirming voice therapy. Individual, semistructured interviews with 15 transgender and gender-diverse voice clients considering voice therapy were conducted and explored using qualitative content analysis. Three themes were identified during the analysis of the participants' narratives. In the first theme, "the incongruent voice setting the rules," the contribution of the voice on the experienced gender dysphoria is put in focus. The second theme, "to reach a voice of my own choice," centers around anticipated personal gains using a modified voice. The third theme, "a voice out of reach," relates to worries and restricting factors for not being able to reach one's set goals for voice modification. The interviews clearly indicate a need for a person-centered voice therapy that starts from the individuals' expressed motives for modifying the voice yet also are affirmative of anticipated difficulties related to voice modification. We recommend that these themes should form the basis of the pretherapy joint discussion between the voice client and the speech-language pathologist to ensure therapy goals that are realistic and relevant to the client.

Efficacy of the DoctorVox Voice Therapy Technique for the Management of Vocal Fold Nodules.

Vocal fold nodules (VFNs) are among the most common causes of dysphonia. Phono-laryngeal microsurgery, pharmacological treatments, and voice therapy (VT) have been used for treating VFNs. VT has been advocated as the primary treatment of choice. This study investigated the efficacy of the DoctorVox Voice therapy technique (DVT) for treating VFNs. A total of 38 patients with VFNs and 40 individuals without any voice problem (control group) were included. All patients received the DVT program. Otorhinolaryngology examination, videolaryngostroboscopy (VLS), and acoustic analysis (SPL, mean F0, jitter %, shimmer %, NHR) were performed at pretreatment, one and six months after the end of treatment. The voice handicap index-10 (VHI-10) and the GRB scales were used for perceptual voice evaluation. GRB and VLS scorings were done blindly. Compared with the pretreatment values, the first- and the sixth-month values after treatment demonstrated a significant decrease in VHI-10 (19.5 vs. 5.1), GRB (2.3 vs 0.68 for G value) and VLS scores, SPL (54.4 vs 66.1 dB), F0 (201 vs. 227 Hz), jitter % (1.46 vs 0.85), shimmer % (3.27 vs 2.51), NHR (1.15 vs. 0.46) values among patients. Most of the voice parameters in the sixth month after the DVT program did not differ significantly from those of the control group. The DVT was found to be an effective method in VFN treatment.

Auditory-Perceptual Judgment of Vocal Resonance in Carnatic Singers by Different Groups of Listeners

AimThis study was aimed at evaluating the auditory perceptual judgments of vocal resonance by professional singers, speech-language pathologists (SLP) with singing training, and SLPs without singing training. Objectives(a) To examine the auditory-perceptual judgments of the phonation samples of professional singers obtained before and after resonant voice therapy (RVT) by professional singers, SLPs with singing training, and SLPs without singing training. (b) To compare the agreement between the auditory-perceptual judgments of the phonation samples obtained before and after RVT by professional singers, SLPs with singing training, and SLPs without singing training MethodThree groups of judges formed the participants of the study: group A (professional singers), group B (SLPs with singing training), and group C (SLPs without singing training). The judges were instructed to evaluate the perceptual vocal resonance in the voice samples of two groups of trained Carnatic classical singers.Among these groups, One group received RVT training, and their voice samples were obtained before and after the training, while the other group acted as a control. An auditory perceptual 3-point rating scale was used to rate the vocal resonance. Descriptive and inferential statistical analyses and inter-rater agreement tests were done to understand the auditory perceptual judgment of vocal resonance by the three groups of judges. ResultsThe results of the Wilcoxon signed rank test indicated that the post-training auditory perceptual ratings by group A (│Z│ = 2.66; P = 0.008) and group B (│Z│ = 2.36; P = 0.018) were significantly different from their pre-training perceptual rating scores. The post-training ratings by group C were not statistically different compared to their pre-training scores. Also, good agreement levels were found on the weighted Cohen’s Kappa coefficient test performed on the judgments made by groups A and B. ConclusionThe listeners compare the voice samples to their own internal representations of a voice which would exclusively depend on the experiences of the listeners. In that way, the perception of intricate voice features of singers, like vocal resonance, could be challenging for SLPs with no experience in singing. The results of this study propose specific training in auditory perceptual judgments for SLPs to ensure efficient and independent service delivery to elite vocal performers like singers.

Editorial introductions.

Current Opinion in Otolaryngology & Head and Neck Surgery was launched in 1993. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of otolaryngology and head and neck surgery are divided into 11 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS Jo PattersonJo PattersonDr Jo Patterson is a Professor of Speech and Language Therapist and Associate Head of Research at the University of Liverpool and The Liverpool Head and Neck Centre. Her research portfolio includes proof of concept work, cohort studies, feasibility studies, multi-centre randomized control trials and the development and evaluation of complex interventions. She is committed to involving patients and keeping them central to research and service development. In 2016, she received a Royal College of Speech and Language Therapy Fellowship in recognition of her contribution towards the advancement of the profession, both as an academic and a practicing Speech and Language Therapist. As their specialist advisor, she represents the organisation on a number of committees and councils, contributing towards policy and strategic direction. She has extensively developed research capacity for Speech and Language Therapists nationally through grant and fellowship applications and provision of MSc and PhD supervision, teaching and mentorship. She continues to balance her time between clinical and academic practice. H Fiona RobinsonH Fiona RobinsonMiss Fiona Robinson qualified as a Speech Therapist from Birmingham Polytechnic, UK in 1980, and in 2004, she was awarded Master of Science (Merit) (Advanced practice – Voice) from the University of Newcastle, UK, with study into the efficacy of voice therapy for vocal fold paralysis. In 2006, in recognition of her contribution to the speech and language therapy profession in the UK, Miss Robinson was elected to the Fellowship of the Royal College of Speech and Language Therapists (RCSLT). She has completed a post-graduate certificate in Medical Education at the University of Nottingham, UK with a particular interest in the development of E-learning. Her clinical interests include the diagnosis and rehabilitation of speech and swallowing disorders related to head and neck cancer, including surgical voice restoration, and the management of dysphonia. Currently she is working within the National Health Service (NHS) and is Director of SVS Associates, a company which runs skills training for speech and language therapists. Johannes FaganJohannes FaganDr Johan Fagan is Professor and Chairman of Otorhinolaryngology at the University of Cape Town in South Africa. He has authored 200 peer reviewed articles and book chapters. A major interest has been to advance head and neck surgery in Africa and the Developing World. To this end he self-publishes two free open access textbooks, “The Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery” and the “Open Access Guide to Audiology and Hearing Aids”.

Towards a Vocal and Acoustic Description of Kapa Haka

ObjectiveThe purpose of this study is to analyze the voice used in kapa haka, a contemporary indigenous vocal performance from New Zealand, which includes the well-known haka. This is the first study of its kind and is a preliminary investigation into the vocal and acoustic description of kapa haka. A significant goal of this study is to contribute ideas and potential definitions of vocal qualities to the community of kapa haka trainers that were specific to the genre. This strengths-based project raises up these vocal practices as legitimate and authentic colors within a vocal tradition that has seen generational learning disrupted by colonial interventions and is now flourishing within the community. MethodsEight kapa haka performers (three females, five males) were involved in the study, they were all experienced performers; furthermore, two had formal classical voice training. They were individually recorded speaking and performing three different genres of kapa haka (mōteatea, waiata, and haka); all recordings were in te reo Māori (the Māori language). In addition, electroglottograph (EGG) signals were collected. An auditory-perceptual evaluation of the kapa haka voice was completed by three singer–researcher–pedagogues familiar with Western and non-western genres of singing. They all have experience appropriately collecting and analyzing data from indigenous communities, and they all understand the sociopolitical context of the vocal genre within the local colonial history. A specific evaluation instrument was created, and the results were validated. The acoustic and time-aligned EGG data was annotated at the phoneme level, and the signal analysis was performed in MATLAB. Averaged EGG pulses from /a/ segments were investigated, along with long-term average spectrums of the performances obtained from both the audio signal and the EGG signals. ResultsThe perceptual analysis suggests the biggest difference in vocal styles was between the haka and the other two genres (and speech). The acoustic and EGG results support these findings. ConclusionsCommon characteristics, perceptually and acoustically, were identified in the kapa haka performance styles across the eight performers.

Basic research on voice training game application for children with severe multiple disabilities: By the phasic heart rate responses

Basic research on voice training game application for children with severe multiple disabilities: By the phasic heart rate responses

다문화 초등학생 대상 보이스트레이닝 수업의 설계 원리 연구

The purpose of this study is to present the design principles of specialized voice training classes for multicultural elementary school students to help them learn pronunciation and intonation. This was achieved by reviewing current studies and literature related to voice training, pronunciation, and intonation. Subsequently, a preliminary draft of 20 principles for specialized voice training classes for elementary school students was designed. These principles were then validated and refined through Focus Group Interviews(FGIs) with voice training experts. Through experimentation, a total of 28 principles were developed, the cause was explained step by step. Although this study could not provide quantitative verification of the tested principles, this study is meaningful for providing data that can be used to form guidelines for voice training classes for multicultural elementary school students.

갑상선 절제술 전후 음성치료

Many patients undergone thyroidectomy show subjective voice changes, neck and throat discomfort, lower pitched voice &amp; high pitch difficulty, and hoarseness. These patients need preoperative and postoperative voice therapy. Using TVSQ and PSVT, subjective voice problems and the need for voice therapy were recognized. Before surgery, it is necessary to alleviate psychological difficulties through voice hygiene education and counseling. After surgery, muscle relaxation exercise and massage of the larynx and neck &amp; shoulder, laughing approach, humming, and SOVTE(lip trill) can induce high-pitched voice and reduce the glottal gap.

Content analysis of music education studies related to augmented reality technology

This study aims to examine the studies scanned in Web of Science and Scopus databases between 2006-2020 on the use of augmented reality applications in music education in terms of their descriptive features, methodological features, and outcomes, and to reveal the trends in this field. The criterion sample approach was utilized in this qualitative study, and 35 selected studies were reviewed using the publication classification form and analyzed using the content analysis method. The descriptive and methodological feature data were translated into frequency values using the SPSS 22 program and then interpreted using tables and charts for easy comprehension. Furthermore, the advantages and limitations of AR applications utilized in music education, which were the research's outputs, were coded, organized into relevant categories, and interpreted. The results showed that most studies focused on piano and guitar education for beginners; no studies were undertaken on wind instruments or voice training. Studies, particularly in recent years, have focused on user experience research. Furthermore, it was found that AR applications have the advantages of increasing and facilitating student learning performance, making learning exciting and fun, and providing motivation. Some challenges during use, owing to technical issues and limited field content in the programs, resulted in limited improvements in music education.

Autotuned Voice Cloning Enabling Multilingualism

Abstract: This article describes a neural network-based text-to-speech (TTS) synthesis system that can generate spoken audio in a variety of speaker voices. We show that the proposed model can convert natural-language text-to-speech into a target language, and synthesize and translate natural text-to-speech. We quantify the importance of trained voice modules to obtain the best generalization performance. Finally, using randomly selected speaker embeddings, we show that speech can be synthesized with new speaker voices used in training and that the model learned high-quality speaker representations. We have also introduced a multilingual system and auto-tuner that allows you to translate regular text into another language, which makes multilingualization possible for various applications.

A Novel Technique: Ultrasonography-Guided Botulinum Toxin Injection in Adductor Type Spasmodic Dysphonia

Spasmodic dysphonia (SD) is a rare disease caused by focal dystonia in the laryngeal muscles. The adductor type SD (AdSD), which affects the thyroarytenoid (TA) muscle, is found in 80% of all SD patients. For them, voice therapy and medication are less effective and definitive surgical treatment has not been established yet. Botulinum toxin injection is considered the gold standard treatment. However, patients require regular injections every 3-6 months whenever the effect of botulinum toxin disappears. Therefore, it is essential that injecting botulinum toxin is safe, comfortable, and accurate. Injections are usually performed under the guidance of electromyography or laryngoscopy. Ultrasonography (US) is a familiar device to otorhinolaryngologists and has recently been used to evaluate the laryngeal structures. While US has been used only for diagnosis, it can also be used for treatment. Here, we describe a novel technique that can be used to inject botulinum toxin into the TA muscle via trans-cartilaginous approach under the guidance of US for the treatment of AdSD.

A mixed-method feasibility study of the use of the Complete Vocal Technique (CVT), a pedagogic method to improve the voice and vocal function in singers and actors, in the treatment of patients with muscle tension dysphonia: a study protocol

BackgroundMuscle tension dysphonia (MTD) results from inefficient or ineffective voice production and is the cause of voice and throat complaints in up to 40% of patients presenting with hoarseness. Standard treatment is voice therapy (SLT-VT) delivered by specialist speech therapists in voice disorders (SLT-V). The Complete Vocal Technique (CVT) is a structured, pedagogic method which helps healthy singers and other performers optimise their vocal function enabling them to produce any sound required. The aim of this feasibility study is to investigate whether CVT administered by a trained, non-clinical CVT practitioner (CVT-P) can be applied to patients with MTD before progressing to a pilot randomised control study of CVT voice therapy (CVT-VT) versus SLT-VT.Methods/designIn this feasibility study, we use a mixed-method, single-arm, prospective cohort design. The primary aim is to demonstrate whether CVT-VT can improve the voice and vocal function in patients with MTD in a pilot study using multidimensional assessment methods. Secondary aims are to assess whether (1) a CVT-VT study is feasible to perform; (2) is acceptable to patients, the CVT-P and SLT-VTs; and (3) whether CVT-VT differs from existing SLT-VT techniques. A minimum of 10 consecutive patients with a clinical diagnosis of primary MTD (types I–III) will be recruited over a 6-month period. Up to 6 video sessions of CVT-VT will be delivered by a CVT-P using a video link. The primary outcome will be a change in pre-/post-therapy scores of a self-reported patient questionnaire (Voice Handicap Index (VHI)). Secondary outcomes include changes in throat symptoms (Vocal Tract Discomfort Scale), acoustic/electroglottographic and auditory-perceptual measures of voice. Acceptability of the CVT-VT will be assessed prospectively, concurrently and retrospectively both quantitatively and qualitatively. Differences from SLT-VT will be assessed by performing a deductive thematic analysis of CVT-P transcripts of therapy sessions.ConclusionThis feasibility study will provide important data to support whether to proceed with a randomised controlled pilot study focusing on the effectiveness of the intervention compared to standard SLT-VT. Progression criteria will be based on demonstrating a positive outcome in treatment, successful delivery of the pilot study protocol, acceptability to all stakeholders and satisfactory recruitment rates.Trial registrationClinicalTrials.gov website (NCT05365126 Unique Protocol ID: 19ET004). Registered on 06 May 2022.