Effects of Vocal Hygiene Therapy Added to Pharmacological Treatment on Voice Function and Quality of Life in Adults With Allergic Rhinitis: A Prospective Nonrandomized Controlled Study.

Objectives

This study aimed to investigate changes in nasal symptoms and voice-related outcomes following pharmacological treatment and to examine the complementary role of structured vocal hygiene therapy in voice function, vocal tract discomfort, and quality of life in adults with allergic rhinitis. STUDY

Design

Prospective, nonrandomized, quasi-experimental controlled study.

Methods

A total of 48 adults were evaluated in three groups: pharmacological treatment plus vocal hygiene therapy (PT+VHT), pharmacological treatment only (PT), and healthy control (HC). The allergic rhinitis groups were assessed at preintervention and after the 4-week intervention, whereas the HC group was assessed once. Evaluations included the Total Nasal Symptom Score (TNSS), Rhinitis Quality of Life Scale (RQLS), Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life (V-RQOL), Vocal Tract Discomfort Scale (VTDS), Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), maximum phonation time, s/z ratio, and acoustic and cepstral-spectral measures.

Results

TNSS scores decreased from 7.69 ± 1.66 to 2.63 ± 1.63 in the PT+VHT group (P = 0.001) and from 8.75 ± 2.08 to 3.50 ± 1.51 in the PT group (P < 0.001); no significant postintervention difference was found between the groups (P = 0.344). In both treatment groups, VHI-10, VTDS, and RQLS scores decreased, whereas V-RQOL scores increased (all P < 0.05). Maximum phonation time increased from 11.38 ± 5.17 to 16.00 ± 4.97 seconds in the PT+VHT group (P < 0.001); however, the change in the PT group (P = 0.147) and the postintervention between-group difference (P = 0.357) were not significant. In the PT+VHT group, CAPE-V breathiness, strain, pitch deviation, and loudness deviation scores decreased (all P < 0.05), whereas no significant changes were observed in the PT group. No significant postintervention differences were found between the two treatment groups for these parameters. Direct between-group differences in acoustic and cepstral-spectral measures were limited to a small number of task-specific parameters.

Conclusion

Four weeks of pharmacological treatment was associated with improvements in allergic rhinitis symptoms and patient-reported voice and quality-of-life outcomes. The within-group changes observed in the PT+VHT group suggest that structured vocal hygiene therapy may play a complementary role in selected components of voice function. Nevertheless, most outcome measures did not differ significantly between the two treatment groups in direct postintervention comparisons.