• Juscelina Kubitscheck de Oliveira Santos, Kelly Cristina Alves Silvério, Neide Fátima Cordeiro Diniz Oliveira, and Ana Cristina Côrtes Gama.
• Department of Speech-Language Pathology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
• J Voice. 2016 Nov 1; 30 (6): 769.e1-769.e7.

ObjectiveTo evaluate the effect of transcutaneous electrical nerve stimulation (TENS) with and without tongue trills in women with vocal nodules.Study DesignRandomized, prospective, comparative intra-subject study.MethodsA total of 60 women aged 18-55 years were included. Visual-perceptual assessment of laryngeal configuration, auditory-perceptual assessment of voice quality, acoustic analyses, and self-assessment of phonation effort were assessed after TENS. Sixty participants participants were randomized into two experimental groups: (1) subjects receiving TENS (EG1), (2) subjects receiving TENS plus tongue trills (EG2). The control group was composed of 15 subjects of EG1 and 15 subjects of EG2. The TENS condition involved electrostimulation for 20 minutes. Audio and video perceptual assessments were performed by three speech therapists with expertise in voice; all were blinded to the experimental conditions. The acoustic parameters included were fundamental frequency, jitter, and shimmer during sustained phonation. Subjects also reported the degree of vocal effort before and after TENS.ResultsTENS applied alone or combined with tongue trills aided in glottal closure and in improved comfort during phonation. When the TENS was administered with tongue trills, roughness of voice quality improved.ConclusionTENS applied alone or combined with tongue trills was associated with improved glottal closure and phonation comfort. TENS associated with tongue trills yielded improved voice quality.Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

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