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Most included studies were a low level of evidence. Various treatment techniques were described, including vocal hygiene, abuse/misuse reduction, yawn-sign, chewing, establishing new pitch, and transcutaneous electrical nerve stimulation (TENS). Overall, "in the majority of studies investigated in the present article, nonmedical treatments of [vocal fold nodules] were successful in improving vocal quality, decreasing sizes of vocal fold nodules, and resolving them" (p. 619).
Three included studies examined treatment effects at long-term follow-up. Each study demonstrated treatment effects remained.