{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:44:53Z","timestamp":1791906293748,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T00:00:00Z","timestamp":1687824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Muscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front\u2010line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics\u2010to\u2010noise ratio) and vocal function (fundamental frequency) through a systematic review with meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>Four databases were searched from inception to December 2022, and a manual search was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>The PRISMA extension statement for reporting systematic reviews incorporating a meta\u2010analysis of health care interventions was applied, and a random effects model was used for the meta\u2010analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's <jats:italic>d<\/jats:italic> &gt;\u20090.8). Significant improvements were obtained in jitter in percent (mean difference of \u2212.58; 95% CI \u22121.00 to 0.16), shimmer in percent (mean difference of \u22125.66; 95% CI \u22128.16 to 3.17), and harmonics\u2010to\u2010noise ratio in dB (mean difference of 4.65; 95% CI 1.90\u20137.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics\u2010to\u2010noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high\u2010quality randomized control trials are needed to support evidence\u2010based practice in laryngology. <jats:italic>Laryngoscope<\/jats:italic>, 134:18\u201326, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30850","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T10:45:44Z","timestamp":1687862744000},"page":"18-26","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0086-8163","authenticated-orcid":false,"given":"Ben","family":"Barsties v. Latoszek","sequence":"first","affiliation":[{"name":"Speech\u2010Language Pathology SRH University of Applied Health Sciences  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Watts","sequence":"additional","affiliation":[{"name":"Harris College of Nursing &amp; Health Sciences Texas Christian University  Fort Worth Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Hetjens","sequence":"additional","affiliation":[{"name":"Department for Medical Statistics and Biomathematics, Medical Faculty Mannheim University of Heidelberg  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,27]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Classification Manual for Voice Disorders\u2010I. 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