Randomized controlled trial of supplemental augmentative and alternative communication versus voice rest alone after phonomicrosurgery

Otolaryngol Head Neck Surg. 2015 Mar;152(3):494-500. doi: 10.1177/0194599814566601. Epub 2015 Jan 20.

Abstract

Objective: This randomized trial investigated voice rest and supplemental text-to-speech communication versus voice rest alone on visual analog scale measures of communication effectiveness and magnitude of voice use.

Study design: Randomized clinical trial.

Setting: Multicenter outpatient voice clinics.

Subjects: Thirty-seven patients undergoing phonomicrosurgery.

Methods: Patients undergoing phonomicrosurgery were randomized to voice rest and supplemental text-to-speech communication or voice rest alone. The primary outcome measure was the impact of voice rest on ability to communicate effectively over a 7-day period. Pre- and postoperative magnitude of voice use was also measured as an observational outcome.

Results: Patients randomized to voice rest and supplemental text-to-speech communication reported higher median communication effectiveness on each postoperative day compared to those randomized to voice rest alone, with significantly higher median communication effectiveness on postoperative days 3 (P=.03) and 5 (P=.01). Magnitude of voice use did not differ on any preoperative (P>.05) or postoperative day (P>.05), nor did patients significantly decrease voice use as the surgery date approached (P>.05). However, there was a significant reduction in median voice use pre- to postoperatively across patients (P<.001) with median voice use ranging from 0 to 3 throughout the postoperative week.

Conclusion: Supplemental text-to-speech communication increased patient-perceived communication effectiveness on postoperative days 3 and 5 over voice rest alone. With the prevalence of smartphones and the widespread use of text messaging, supplemental text-to-speech communication may provide an accessible and cost-effective communication option for patients on vocal restrictions.

Keywords: augmentative and alternative communication; randomized controlled trial; text-to-speech; voice; voice disorders; voice rest.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Communication*
  • Female
  • Humans
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Postoperative Period
  • Rest / physiology*
  • Vocal Cords / physiopathology
  • Vocal Cords / surgery*
  • Voice / physiology*
  • Voice Disorders / physiopathology
  • Voice Disorders / surgery*
  • Voice Training*
  • Young Adult