Nonmedical Treatments of Vocal Fold Nodules: A Systematic Review.

OBJECTIVES: The aim of the present systematic review was to investigate the nonmedical treatments of vocal fold nodules (VFNs). STUDY DESIGN: The present study is a systematic review. METHODS: The following electronic databases were searched from inception until August 2016: PubMed, Scopus, ScienceDirect, Ovid, ISI (Web of Sciences), Cochrane, PsychINFO, The Cochrane Central Register of Controlled Trials, and Google Scholar. Reference lists of included articles were evaluated for additional data. Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were used to carry out and report the review. The methodological quality of the articles included was evaluated using the Physiotherapy Evidence Database scale. Due to the heterogeneity of the studies, a narrative synthesis of the evidence was performed to summarize the evidence. RESULTS: Out of 2,099 records identified, 21 articles met the inclusion criteria and thus were included in the review. The studies investigated in the present review were different in terms of study design, participant characteristics, types of assessments and treatments, and treatment delivery. However, nonmedical treatments of VFNs were found to be successful in improving vocal quality, decreasing VFN sizes, and resolving these nodules. CONCLUSIONS: The results of the present review could provide primary evidence related to the effectiveness of nonmedical treatment of VFNs. Yet further studies with a high level of evidence, a rigorous methodological quality, and long-term follow-up evaluations are required to make stronger claims.