Efficacy of straw phonation exercises with breathing exercises and indirect approaches for dysphonic adults with benign vocal fold lesions

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Chanakarn Haowutikul
Jeamjai Jeeraumporn
Sumalee Dechongkit
Sawitri Thayansin


Background: The voice is essential to a people’s daily life, especially in occupational voice users who are at risk for benign vocal fold lesions. It is important to use the proper vocal therapy techniques on a dysphonic patient who has benign vocal fold lesions in order to reduce behaviors that will aggravate the voice disorder and enhance behaviors that help improve voice quality.

Objectives: The purpose of this study was to evaluate the efficacy of straw phonation exercises with breathing exercises and indirect approaches in dysphonic adults with benign vocal fold lesions, including vocal nodules; vocal polyps, and vocal cysts.

Materials and methods: This study was a pilot study. Twelve participants who had benign vocal fold lesions received vocal hygiene guidance, abdominal breathing exercises, muscle relaxation, and straw phonation voice therapy. All participants received 8 weekly therapy sessions: 30 minutes per session. The vocal assessment data was collected before the first voice therapy session, and immediately after the eighth session, by subjective vocal assessment, and objective vocal assessment with Dr. Speech software version 5.

Results: The results after therapy showed significant improvements against the GIRBAS scales in terms of the subjective vocal assessment, in the values of SD F0, jitter, NNE, and MPT of the objective vocal assessment.

Conclusion: This result indicates straw phonation with breathing exercises and indirect approaches as being a worthwhile alternative method for voice therapy in dysphonic patients with benign vocal fold lesions.


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Haowutikul, C., Jeeraumporn, J., Dechongkit, S., & Thayansin, S. (2023). Efficacy of straw phonation exercises with breathing exercises and indirect approaches for dysphonic adults with benign vocal fold lesions. Journal of Associated Medical Sciences, 56(2), 47–52. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/257240
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