# Immediate Effects of Nasalance Exercises on Patients with Organic Dysphonia

## TL;DR

This study examines how nasalance exercises immediately affect vocal fold vibrations in patients with voice disorders, finding that the effects are not consistent or long-lasting.

## Contribution

The study provides new insights into the immediate but non-persistent effects of nasalance exercises on vocal parameters in patients with organic dysphonia.

## Key findings

- Nasalance increased immediately after exercises in 6 out of 7 subjects.
- Voice parameters like OQ, ClQ, and Jitter showed variable changes but no consistent stabilization.
- The effects on voice parameters did not persist 10 minutes after the exercises.

## Abstract

Nasalance exercises (also known as resonance exercises) are widely used in voice therapy. Understanding their effects can guide therapeutic approaches and surgical decisions.

To analyze the immediate effects of nasalance exercises on vocal fold oscillation in patients with vocal fold mass lesions and a recommendation for phonosurgery.

Prospective observational study following the STROBE guidelines.

Department of Phoniatrics, university hospital.

Seven patients with vocal fold mass lesions (6 with polyps, 1 with Reinke edema) and indication for surgery.

Participants performed nasalance exercises for 10 minutes. Recordings were taken before the exercise (pre), immediately after (post0), and 10 minutes after completion (post10). Subjects phonated vowel [i:] on a sustained pitch (250 Hz for females, 125 Hz for males) at a comfortable level of loudness.

Data were collected using transnasal high-speed videoendoscopy, a Rothenberg mask for airflow measurement, electroglottography, and audio recordings. Extracted parameters were: nasalance, open quotient (OQ), closing quotient (ClQ), sound pressure level (SPL), Jitter, and cepstral peak prominence (CPP).

Nasalance increased immediately after the exercises for 6 out of 7 subjects. OQ values varied: they increased in 3 subjects, decreased in 3, and remained unchanged in 1. No consistent relationship was found between SPL and ClQ. Jitter increased in 5 subjects. CPP did not show clear tendencies. The effects on voice parameters did not persist 10 minutes postexercise. There were no significant correlations with age, sex, or preintervention voice indices (Voice Handicap Index, Dysphonia Severity Index).

In patients with organic dysphonia and an indication for surgery, a raised nasalance value directly after the execution of nasalance exercises does not necessarily lead to stabilized voice parameters, and the possible effects do not seem to be persistent.

Nasalance exercises might not provide sustained benefits in stabilizing vocal fold vibrations in subjects with an indication for surgery.

Graphical Abstract