Direct and Indirect Voice Therapy Approaches for Unloading the Laryngeal Mechanism in Professional Voice Users

Purpose of ReviewThe objective of this paper is to describe and synthesize current practices in voice therapy for unloading the laryngeal mechanism in professional voice users with hyperfunctional voice disorders.Recent FindingsProfessional voice users carry an increased risk of hyperfunctional voice disorders due to their high vocal demands. Phonotraumatic (e.g., vocal fold nodules) and non-phonotraumatic (e.g., primary muscle tension dysphonia) manifestations of vocal hyperfunction are associated with excessive and imbalanced muscular activity during phonation, and patients with vocal hyperfunction are typically referred for voice therapy as first-line treatment. Recent studies have detailed direct and indirect therapeutic interventions for balancing the vocal subsystems and reducing excessive muscle activation during phonation.Direct and indirect voice therapy methods can be utilized to rebalance the vocal mechanism in the treatment of professional voice users with vocal hyperfunction. These methods are described in detail.