Rihkanen Heikki, Geneid Ahmed
Department of Otorhinolaryngology and Phoniatrics, Helsinki University Hospital, University of Helsinki, Post Box 263, 00029, Helsinki, Finland.
Eur Arch Otorhinolaryngol. 2019 Feb;276(2):483-487. doi: 10.1007/s00405-019-05283-1. Epub 2019 Jan 10.
After surgery of vocal folds, almost every patient will need some voice rest. It is common to recommend total silence for some days, followed by less restricted voice use for variable periods. By now, we do not know how voice rest affects the healing process or the current practise in Europe.
Members of the European Laryngological Society (2012) and the Union of European Phoniatrics (2018) were sent a web-based questionnaire which included two patient cases with a short history and a still picture. The respondents were asked about the postoperative recommendation of absolute voice rest and sick leave.
Over 90% of the respondents would recommend absolute voice rest after removing a polyp or after mucosal repair of Reinke's oedema. For both cases, the mean length of recommended absolute voice rest among UEP members was 4 days (range 0-10 days) and among ELS members was 5 days (range 0-14 days). The recommended sick leave ranged from 0 to 35 days. The mean figures suggested by ELS members for the receptionist with Reinke's oedema were 12 days and for the teacher with a polyp 13 days. On average, UEP members recommended 14 days of sick leave for both cases.
The present scientific evidence is scant, but does not support for prolonged (over 3 days) absolute voice rest after simple phonosurgery. So far, there are no studies that could show absolute voice rest to be superior over relative voice rest. According to the present survey, there is considerable variation in recommending voice rest and sick leave after the removal of benign mucosal lesions. Many European laryngologists suggest voice rest that is longer and stricter than the present scientific literature supports.
声带手术后，几乎每位患者都需要进行一段时间的禁声。通常建议患者完全噤声数日，之后在不同时间段内逐渐放宽对发声的限制。目前，我们尚不清楚禁声如何影响愈合过程，也不了解欧洲的现行做法。
向欧洲喉科学会（2012年）和欧洲语音治疗学会（2018年）的成员发送了一份基于网络的调查问卷，其中包含两个病史简短的患者病例及一张静态图片。受访者被问及术后绝对禁声的建议及病假时长。
超过90%的受访者会建议在切除息肉或修复Reinke水肿的黏膜后进行绝对禁声。对于这两种情况，欧洲语音治疗学会成员建议的绝对禁声平均时长为4天（范围0 - 10天），欧洲喉科学会成员为5天（范围0 - 14天）。建议的病假时长从0天至35天不等。欧洲喉科学会成员针对患有Reinke水肿的接待员建议的平均病假天数为12天，针对患有息肉的教师建议为13天。欧洲语音治疗学会成员平均针对这两种情况都建议14天病假。
目前科学证据不足，但不支持单纯的嗓音手术后长时间（超过3天）绝对禁声。迄今为止，尚无研究表明绝对禁声优于相对禁声。根据本次调查，在建议切除良性黏膜病变后的禁声和病假方面存在相当大的差异。许多欧洲喉科医生建议的禁声时间比目前科学文献所支持的更长、更严格。
