Randomized Controlled Trial of Supplemental Augmentative and Alternative Communication versus Voice Rest Alone after Phonomicrosurgery. (March 2015)

• Record Type: Journal Article
• Authors: Rousseau, Bernard; Gutmann, Michelle L.; Mau, Theodore; Francis, David O.; Johnson, Jeffrey P.; Novaleski, Carolyn K.; Vinson, Kimberly N.; Garrett, C. Gaelyn
• Is Part Of: Otolaryngology--head and neck surgery. Volume 152:Number 3(2015:Mar.)
• Page Start: 494
• Page End: 500
• Publication Date: 2015-03
• Subjects: randomized controlled trial -- voice -- voice disorders -- voice rest -- text-to-speech -- augmentative and alternative communication; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814566601
• Languages: English
• ISSNs: 0194-5998

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.