Abstract
Background/Objectives: Manual laryngeal therapy is used in conservative behavioral management and encompasses hands-on techniques to address functional manifestations of dysphonia, dysphagia, and laryngeal discomfort. However, evidence regarding clinical indications, treatment protocols, and outcomes remains heterogeneous. This review mapped the available evidence on manual laryngeal therapy approaches, treated populations, outcome measures, and reported treatment effects. Methods: Following PRISMA-ScR guidelines, 6 databases were searched from inception to 26 August 2026, as well as grey literature. Primary studies and meta-analyses were charted separately to distinguish evidence levels and avoid double-counting. Study characteristics, clinical populations, therapeutic approaches, outcome measures, and reported treatment effects were extracted and synthesized descriptively. Results: The review identified 41 eligible publications comprising 4 meta-analyses and 37 primary studies, which comprised randomized controlled trials (n = 12), cohort studies (n = 5), case series (n = 12), and case studies (n = 8). Evidence concerned voice disorders, with Laryngeal Manual Therapy (LMT; 29.8%) and Manual Circumlaryngeal Therapy (MCT; 27.0%) representing the most frequently investigated approaches, followed by Voice Massage and Cricothyroid Visor Maneuver (each 8.1%), Larynx Manipulation and Vanderbilt Manual Intervention (each 5.4%), and other single evaluated manual techniques/approaches (16.2%). Treatment protocols and outcome measures varied substantially. Significant positive effects were reported for 53% of statistically assessable LMT outcome parameters and 62% of MCT. Meta-analyses consistently reported significant improvements in voice quality parameters following MCT, alongside benefits in selected voice function and articulation measures. Conversely, a meta-analysis investigating LMT found no significant improvements in perceived voice quality or self-evaluation compared with voice exercises or transcutaneous electrical nerve stimulation. Conclusions: Manual laryngeal therapy has mostly been investigated in functional voice disorders. Evidence suggests combined manual techniques with voice exercises to benefit voice outcomes, while passive treatment may better address laryngeal discomfort and related symptoms. Standardized protocols, diagnosis-specific outcome measures, and controlled studies are needed to establish clinical effectiveness.