Department of Surgery, University of Wisconsin-Madison.
Department of Communication Sciences and Disorders, University of Wisconsin-Madison.
Am J Speech Lang Pathol. 2022 Mar 10;31(2):912-922. doi: 10.1044/2021_AJSLP-21-00115. Epub 2022 Feb 18.
Voice rest is frequently prescribed after phonosurgery, but optimal type and duration for voice outcomes have not been demonstrated. Studies to date have been characterized by heterogeneity in surgical procedures and laryngeal diagnoses. We sought to analyze the effect of recommended absolute voice rest duration on outcomes of microflap surgery for benign vocal fold lesions. A secondary purpose was to identify patient factors associated with postoperative voice outcomes.
Forty-three patients were included in this retrospective review of patients aged 18 years and above who underwent direct microlaryngoscopy with microflap for vocal fold polyp or cyst over a 5-year period at a multidisciplinary voice center. Duration of recommended postoperative absolute voice rest was classified as less than 7 days, 7 days, and more than 7 days. Demographic and vocal hygiene data and voice treatment history were collected. Outcome measures consisted of one pre- and two postoperative Voice Handicap Index (VHI) scores. Effects of recommended voice rest on outcomes were analyzed using mixed models for repeated measures. Effects of patient factors on outcomes were analyzed as exploratory measures. Stroboscopy ratings were analyzed descriptively.
Thirteen patients were recommended 7 days of absolute voice rest, 15 were recommended less than 7 days, and 15 were recommended more than 7 days. Postoperatively, VHI scores significantly improved for all patients. Voice rest as a continuous variable was associated with the Functional subscale score in the short term, but there was no effect on VHI total score and no longer term effect of voice rest on any outcome. Age, sex, and preoperative voice therapy were associated with at least one VHI subscale score on at least one time point.
VHI outcomes of microflap surgery for polyps and cysts do not differ by duration of recommended absolute postoperative voice rest.
喉显微手术后常嘱患者进行嗓音休息，但尚未证实嗓音休息的最佳类型和持续时间对嗓音结果的影响。迄今为止的研究特点是手术程序和喉部诊断存在异质性。我们旨在分析推荐的绝对嗓音休息持续时间对良性声带病变行微瓣手术结局的影响。次要目的是确定与术后嗓音结果相关的患者因素。
本回顾性研究纳入了在 5 年内于多学科嗓音中心接受直接显微镜下声带微瓣手术治疗声带息肉或囊肿的 43 例年龄 18 岁及以上患者。将推荐的术后绝对嗓音休息持续时间分为少于 7 天、7 天和多于 7 天。收集了人口统计学和嗓音卫生数据以及嗓音治疗史。结局指标包括术前和术后 2 次嗓音障碍指数（VHI）评分。采用重复测量混合模型分析推荐嗓音休息对结局的影响。采用探索性措施分析患者因素对结局的影响。频闪喉镜评估结果进行描述性分析。
13 例患者被建议休息 7 天，15 例被建议休息少于 7 天，15 例被建议休息多于 7 天。所有患者术后 VHI 评分均显著改善。嗓音休息作为连续变量与短期的功能子量表评分相关，但对 VHI 总分无影响，且嗓音休息对任何结局均无长期影响。年龄、性别和术前嗓音治疗与至少一个 VHI 子量表评分在至少一个时间点相关。
微瓣手术治疗息肉和囊肿的 VHI 结局不因推荐的术后绝对嗓音休息持续时间而异。
