Efficacy of voice training on benign vocal cord lesions after surgery: A systematic review, meta-analysis, and trial sequential analysis of randomized clinical trials

手术后声带良性病变患者接受语音训练的疗效:随机临床试验的系统评价、荟萃分析和试验序贯分析

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Abstract

BACKGROUND: Voice training (VT) aids patients in achieving or restoring physiological harmony among the vocal organs and in correcting the faulty conditioned reflexes induced by benign vocal cord lesions (BVLs). Herein, we designed a systematic review and meta-analysis for the first time to evaluate the effect of VT on BVLs after surgery based on several outcomes. METHODS: Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane Library) and 3 Chinese databases (CNKI, VIP, and Wanfang) were searched through September 26, 2024, without any restrictions. We used Review Manager, version 5.3 for meta-analysis and presented the data as standardized mean difference (SMD) or risk ratio (RR) and 95% confidence interval (CI). RESULTS: A total of 1771 records were retrieved from 7 databases that 22 articles were entered into the meta-analysis. The pooled RR for total effective rate was 1.14 (P = .0009). The pooled SMD for G was -1.64 (P < .00001), for R was -1.76 (P < .00001), and for B was -3.70 (P < .0001). The results showed a 14% improvement in the intervention group compared to the control group. The pooled SMD for VHI-T was -1.57 (P < .00001), for VHI-E was -1.04 (P < .00001), for VHI-F was -0.93 (P < .00001), and for VHI-P was -1.11 (P < .00001). The pooled SMD for jitter was -1.55 (P < .00001), for shimmer was -1.29 (P < .00001), for maximum phonation time (MPT) was 0.80 (P < .00001), for dysphonia severity index (DSI) was 2.63 (P < .0001), for NHR was -0.73 (P = .05). CONCLUSIONS: The intervention group showed marked improvements across various metrics compared to the control group, with a 14% increase in total effective rate and notable reductions in G, R, B, VHI-T, VHI-E, VHI-F, VHI-P, jitter, and shimmer. There were also significant increases in MPT and DSI, with NHR remaining unchanged.

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