Division of Otolaryngology, Head and Neck Surgery, University of Wisconsin-Madison, Wisconsin Institute of Medical Research, Madison, Wisconsin 53705-2275, USA.
J Voice. 2010 Jul;24(4):379-87. doi: 10.1016/j.jvoice.2008.10.011. Epub 2009 Aug 5.
Voice rest is commonly prescribed after vocal fold surgery to promote wound healing of the vocal fold. Currently, there is no standard protocol that is established based on biological evidence. In orthopedic rehabilitation, long-term rest is found to be less effective for connective tissue healing than exercise. Connective tissue healing is also an important factor for successful voice rehabilitation; however, whether this concept can be extrapolated to voice rehabilitation is unknown. The purpose of this article is to review current clinical and basic science literature to examine the effect of voice rest in postsurgical rehabilitation. First, we present a summary of clinical literature that pertains to voice rest. Second, we present description of connective tissues that are involved in orthopedic and voice rehabilitation, specifically, ligament and lamina propria, respectively, and their wound healing process. Third, a summary of the literature from orthopedic research on the effect of rest versus exercise is presented. Lastly, it summarizes in vitro and in vivo studies that examined the effect of mechanical stress on vocal fold tissue. Current literature suggests that there is a lack of clinical evidence that supports a specific type and duration of voice rest, and extrapolation of the findings from orthopedic research may be unreasonable due to the morphological and biochemical difference between the tissues. To determine the effect of voice rest, further elucidation of vocal fold wound healing process and the effect of mechanical stress on vocal fold tissue remodeling are needed.
声带手术后通常会建议患者进行嗓音休息，以促进声带的伤口愈合。目前，还没有基于生物学证据建立的标准方案。在骨科康复中，长期休息被发现对结缔组织的愈合效果不如运动。结缔组织的愈合也是成功进行嗓音康复的重要因素；然而，这一概念是否可以推广到嗓音康复领域尚不清楚。本文的目的是回顾当前的临床和基础科学文献，以检查嗓音休息在术后康复中的作用。首先，我们总结了与嗓音休息相关的临床文献。其次，我们介绍了参与骨科和嗓音康复的结缔组织，分别是韧带和固有层，以及它们的伤口愈合过程。第三，我们总结了骨科研究中关于休息与运动对韧带和固有层影响的文献。最后，总结了体外和体内研究检查机械应激对声带组织的影响。目前的文献表明，缺乏支持特定类型和持续时间的嗓音休息的临床证据，并且由于组织的形态和生化差异，从骨科研究中推断结果可能不合理。为了确定嗓音休息的效果，需要进一步阐明声带伤口愈合过程以及机械应激对声带组织重塑的影响。
