Department of Oto-Rhino-Laryngology and Reconstructive Cervicofacial Surgery, Hopital Foch 40 Rue Worth, 92150, Suresnes, France.
Laryngoscope. 2013 Aug;123(8):1926-30. doi: 10.1002/lary.23768. Epub 2013 Jun 11.
OBJECTIVES/HYPOTHESIS: To evaluate the long-term outcome of patients with vocal fold nodules treated by surgery alone, or by a combination of surgery and voice therapy and to identify factors associated with long-term recurrent dysphonia.
Retrospective study.
All patients who had undergone surgery for vocal fold nodules in a tertiary care hospital between 1996 and 2006 were contacted. After giving their consent, they were evaluated by videostroboscopic examination of vocal fold nodules and by a subjective questionnaire including the Voice Handicap Index (VHI).
Sixty-two out of 90 patients (69%) (60 women, 2 men with a mean age of 33 years) answered the questionnaire at a mean interval of 9.5 years after surgery. Recurrent dysphonia was observed in 19 patients (30%) at a mean interval of 5.2 years after surgery and new benign vocal fold lesions (nodules or Reinke's edema) were observed in 11 patients (18%). Absence of postoperative voice therapy was significantly associated with a higher recurrence rate (P = 0.02) (56% of recurrent dysphonia without voice therapy versus 22% with voice therapy).
Postoperative voice therapy decreases the risk of recurrence. Vocal fold nodules can recur over a period of 5 years, consequently requiring follow-up for at least 5 years in clinical practice and in future prospective studies.
目的/假设：评估单独手术或手术联合语音治疗治疗声带小结患者的长期疗效，并确定与长期复发性声音障碍相关的因素。
回顾性研究。
联系了 1996 年至 2006 年期间在一家三级保健医院因声带小结接受手术的所有患者。在获得他们的同意后，通过声带小结的频闪喉镜检查和包括嗓音障碍指数（VHI）在内的主观问卷对他们进行评估。
62 名患者（69%）（60 名女性，2 名男性，平均年龄 33 岁）在手术后平均 9.5 年回答了问卷。19 名患者（30%）在手术后平均 5.2 年出现复发性声音障碍，11 名患者（18%）出现新的良性声带病变（小结或 Reinke 水肿）。术后未行语音治疗与更高的复发率显著相关（P=0.02）（无语音治疗的复发性声音障碍为 56%，有语音治疗的为 22%）。
术后语音治疗可降低复发风险。声带小结可在 5 年内复发，因此在临床实践中和未来的前瞻性研究中，需要至少随访 5 年。
