The role of voice rest after micro-laryngeal surgery for benign vocal fold lesions

Purpose This study attempts to gain insights into the role of daily voice use in the etiology and pathophysiology of phonotraumatic vocal hyperfunction (PVH) by applying a logistic regression-based daily phonotrauma index (DPI) to predict group-based improvements in patients with PVH after laryngeal surgery and/or postsurgical voice therapy. Method A custom-designed ambulatory voice monitor was used to collect 1 week of pre- and postsurgery data from 27 female patients with PVH; 13 of these patients were also monitored after postsurgical voice therapy. Normative weeklong data were obtained from 27 matched controls. Each week was represented by the DPI, standard deviation of the difference between the first and second harmonic amplitudes (H1–H2). Results Compared to pretreatment, the DPI significantly decreased in the patient group after surgery (Cohen's d effect size = −0.86) and voice therapy ( d = −1.06). The patient group DPI only normalized after voice therapy. Conclusions The DPI produced the expected pattern of improved ambulatory voice use across laryngeal surgery and postsurgical voice therapy in a group of patients with PVH. The results were interpreted as providing new objective information about the role of daily voice use in the etiology and pathophysiology of PVH. The DPI is viewed as an estimate of potential vocal fold trauma that relies on combining the long-term distributional characteristics of two parameters representing the magnitude of phonatory forces (neck-surface acceleration magnitude) and vocal fold closure dynamics (H1–H2). Further validation of the DPI is needed to better understand its potential clinical use.

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The Role of Oral Steroids in the Treatment of Phonotraumatic Vocal Fold Lesions in Women

Otolaryngology ◽

10.1177/0194599818804776 ◽

2018 ◽

Vol 160 (3) ◽

pp. 512-518 ◽

Cited By ~ 3

Author(s):

Milan R. Amin ◽

Stratos Achlatis ◽

Shirley Gherson ◽

Yixin Fang ◽

Binhuan Wang ◽

...

Keyword(s):

Vocal Fold ◽

Care Center ◽

Primary Outcome Measure ◽

Voice Therapy ◽

Controlled Clinical Trial ◽

Double Blind ◽

Benign Vocal Fold Lesions ◽

Short Course ◽

Oral Steroids

Objectives (1) To determine the short-term effectiveness of oral steroids in women with benign vocal fold lesions and (2) to determine the effectiveness of adjuvant oral steroids in women undergoing voice therapy for benign vocal fold lesions. Study Design Randomized, double-blind, placebo-controlled clinical trial. Setting Tertiary voice care center. Subjects and Methods Thirty-six patients undergoing voice therapy for the treatment of phonotraumatic vocal fold lesions randomly received either a 4-day course of oral steroids or a placebo prior to initiating voice therapy. Voice Handicap Index–10 (VHI-10) scores, video and audioperceptual analyses, acoustic and aerodynamic analyses at baseline, and patient perception of improvement after a short course of steroids or a placebo and at the conclusion of voice therapy were collected. Results Thirty patients completed the study, of whom 27 (only female) were analyzed. The primary outcome measure, VHI-10, did not improve after the 4-day course of steroids or placebo. Secondary measures similarly showed no improvement with steroids relative to placebo. Voice therapy demonstrated a positive effect on both VHI-10 and patient-perceived improvement of voice in all subjects. Conclusion A short course of oral steroids did not benefit women with phonotraumatic vocal fold lesions. In addition, steroids had little beneficial effect when used adjunctively with voice therapy in this patient cohort.

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Vocal outcomes after video assisted cold knife endolaryngeal phonosurgery of benign vocal fold lesions

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20214226 ◽

2021 ◽

Vol 7 (11) ◽

pp. 1757

Author(s):

Sanjeev Mishra ◽

Aishwarya Ullal ◽

Shiv Kumar Rathaur

Keyword(s):

Vocal Fold ◽

Conservative Therapy ◽

High Definition ◽

Video Assisted ◽

Laryngeal Surgery ◽

Benign Vocal Fold Lesions ◽

Voice Outcome ◽

Endolaryngeal Surgery ◽

Static Images ◽

Cold Knife

Background: This study focuses on therapeutic possibilities in managing benign superficial vocal fold lesions with video assisted cold knife endolaryngeal phonosurgery.Methods: Fifty patients with benign vocal fold lesions presented to us between September 2013 and October 2015 who failed conservative therapy were subjected to video assisted cold knife endolaryngeal phonosurgery. The pre and postoperative results were evaluated based on voice rating by visual analogue scale and GRBAS scale.Results: Encouraging results were achieved with cold knife endolaryngeal surgery as 96.3% of patients were symptom free without any recurrence after single operation. Most of them have achieved >90% of voice outcome by 1 month postoperatively based on voice assessment and laryngoscopic evaluation.Conclusions: Using a telescope with high definition video system for performing phonosurgery is economic, enables the surgeon to acquire static images and video sequences. Cold knife endoscopic laryngeal surgery is possibly a better option for addressing BVFLs.

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Videoendoscopic Laryngeal Surgery

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940010900207 ◽

2000 ◽

Vol 109 (2) ◽

pp. 149-155 ◽

Cited By ~ 34

Author(s):

Koichi Omori ◽

Tomoko Tsuji ◽

Kaoru Shinohara ◽

Hisayoshi Kojima

Keyword(s):

High Resolution ◽

Vocal Fold ◽

Charge Coupled Device ◽

Vocal Function ◽

Laryngeal Surgery ◽

Benign Vocal Fold Lesions ◽

Laryngeal Lesions ◽

Laryngeal Tumors ◽

High Resolution Images ◽

Device Chip

This paper introduces videoendoscope-assisted laryngeal surgery with office-based equipment. With this technique, a patient is seated and the nose, pharynx, and larynx are topically anesthetized. A flexible videoendoscope with a light-sensitive charge-coupled device chip built into the tip is transnasally inserted by an assistant. Specially designed fine-tipped forceps and scalpels were developed for removal of laryngeal lesions. Videoendoscopic laryngeal surgery was undertaken in 114 cases of laryngeal lesions such as polyps, granuloma, and cancer. For benign vocal fold lesions, postoperative vocal function was shown to be improved on aerodynamic and perceptual analyses. For laryngeal tumors, biopsy of the lesion was easily undertaken. Videoendoscopic laryngeal surgery presents the following advantages. It is applicable to outpatients not requiring general anesthesia, it enables functional monitoring of the patient's voice and vocal fold during phonation, it allows for delicate manipulations with both hands, and it gives high-resolution images in comparison to conventional fiberscopy.

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Pediatric Benign Vocal Fold Lesions: A Team Approach

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd19.3.105 ◽

2009 ◽

Vol 19 (3) ◽

pp. 105-112 ◽

Cited By ~ 3

Author(s):

Geralyn Harvey Woodnorth ◽

Roger C. Nuss

Keyword(s):

Vocal Fold ◽

Evaluation Process ◽

Team Approach ◽

Speech Language Pathologist ◽

Benign Vocal Fold Lesions ◽

Different Types ◽

Team Evaluation ◽

Surgical Treatments ◽

Review Current ◽

Vocal Fold Nodules

Abstract Many children with dysphonia present with benign vocal fold lesions, including bilateral vocal fold nodules, cysts, vocal fold varices, and scarring. Evaluation and treatment of these children are best undertaken in a thoughtful and coordinated manner involving both the speech-language pathologist and the otolaryngologist. The goals of this article are (a) to describe the team evaluation process based on a “whole system” approach; (b) to discuss etiological factors and diagnosis; and (c) to review current medical, behavioral, and surgical treatments for children with different types of dysphonia.

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