الفهرس 
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Abstract
The overall goal for the patient who still having dysphonia after the micro-layngeal phonosurgery is optimal long-term voice quality and communication function with minimal recurrence.
Assessment and management should be both efficient and effective. The Accent Method of voice therapy is an integral component of intervention and contributes to improve any faulty vocal habits and reduce occasional post-operative vocal fold congestion.
The basic principle of microlaryngeal phonosurgery is to maintain or improve the functional structure of the vocal folds by respecting its layered structure. This is achieved by means of minimal tissue excision, minimal disruption of the superficial layer of the lamina propria and preservation of the epithelium especially at the vibrating edge.
Patient improvement is noted when the follow-up reveals changes in behaviors under treatment. In addition, progress in both subjective and objective parameters. The role of ”Accent Method” exercises after microlaryngeal phonosurgery is documented only when the influence of other potential treatment variables is ruled out. This goal is attained when controlled documented research is conducted which also demonstrate clinician’s accountability.
The role of the Accent Method of voice therapy after microlaryngeal phonosurgery was evaluated in this study in a controlled setup that eliminated the other independent variables. The study group (G1) which received the complete course of voice therapy and the voice hygiene advice group (G2) were comparable in all parameters except that (G1) only received the Accent exercises.
Holding of the Accent exercises did not cause any ethical disagreement, as the patients in (G2) were followed up and were being prepared eventually to receive the accent exercises later on.
This model of a comparative clinical study aiming to demonstrate the role of the Accent exercises after microlaryngeal phonosurgery which is believed to be most suited to a behavior readjustment therapy.
The accent method (AM) of voice therapy is one of the holistic approaches for behavior readjustment therapy. It is holistic in the general sense of verbal communication as it integrates the improvement of the respiratory, phonatory and articulatory activities. It tackles collectively and simultaneously the various parameters of voice such as pitch, loudness and timbre.
As the minimal associated pathological lesions (MAPLs) of the vocal folds is a result of phonotrauma (abuse and misuse of voice). Voice use after microlaryngeal phonosurgery is step-by-step during the healing phase. After the first week of voice rest, voice may be still dysphonic but acceptable for a limited use.
Having the course of Accent Method of voice therapy after doing micro-laryngeal phonosurgery is almost always a good idea in order to make the person aware of circumstances and habits of voice use that may have led to recurrence of the lesion in the first place.
Voice training enables patients to establish or re-establish the physiological balance among the vocal organs and to correct the erroneous conditioned reflex caused by the vocal fold lesions to enable restoration of normal phonation function through changing the vocal environment and condition of the patients.