Aldaihani A, Kuta V, Alamodi U, AlAfif A, AlSayed A
Department of Surgery, Dalhousie University, 5820 University Avenue, 3Rd Floor Dickson Building, Room 3184, Halifax, NS, B3H 2Y9, Canada.
AdventHealth Center, Orlando, Florida, USA.
Eur Arch Otorhinolaryngol. 2025 May 30. doi: 10.1007/s00405-025-09470-1.
Vocal rest (VR) is frequently recommended to promote healing and prevent further trauma following vocal cord surgery, despite limited empirical evidence supporting this practice. This systematic review aimed to evaluate the efficacy of VR in facilitating recovery and improving outcomes after vocal cord surgery.
A systematic review of randomized controlled trials (RCTs) comparing VR versus no VR after vocal cord surgery was conducted. Two independent reviewers screened studies from PubMed, Medline, Web of Science, Embase, Cochrane, and Google Scholar using predefined search terms, including "vocal rest after vocal cord surgery," "vocal rest versus no rest after vocal cord surgery," and "voice rest after laryngeal surgery." Inter-reviewer agreement was assessed using the kappa statistic. Studies meeting inclusion criteria were analyzed for key outcomes, including the Visual Analog Scale (VAS) for voice quality and the Voice Handicap Index (VHI).
Of the 275 articles identified, only 5 met the inclusion criteria. The duration of VR varied from 3 to 7 days, depending on surgeons' preferences and clinical experience. Results demonstrated significant improvements in both VAS and VHI scores after surgery with VR compared to no VR. However, heterogeneity in study designs and sample sizes limited the generalizability of these findings.
While VR appears to enhance postoperative recovery and subjective voice quality following vocal cord surgery, the current evidence base remains insufficient to establish VR as a definitive component of postoperative care. Larger, multicenter RCTs are needed to elucidate the role of VR in vocal wound healing and to develop evidence-based guidelines.
尽管支持声带手术后进行声带休息（VR）这一做法的实证证据有限，但仍经常推荐进行声带休息以促进愈合并防止进一步创伤。本系统评价旨在评估声带休息在声带手术后促进恢复和改善预后方面的疗效。
对比较声带手术后声带休息与不进行声带休息的随机对照试验（RCT）进行系统评价。两名独立评审员使用预定义的检索词，包括“声带手术后的声带休息”“声带手术后声带休息与不休息对比”以及“喉手术后的嗓音休息”，从PubMed、Medline、科学网、Embase、Cochrane和谷歌学术中筛选研究。使用kappa统计量评估评审员间的一致性。对符合纳入标准的研究分析关键结局，包括嗓音质量视觉模拟量表（VAS）和嗓音障碍指数（VHI）。
在识别出的275篇文章中，仅有5篇符合纳入标准。声带休息的时长从3天到7天不等，取决于外科医生的偏好和临床经验。结果表明，与不进行声带休息相比，声带手术后进行声带休息的患者在VAS和VHI评分上均有显著改善。然而，研究设计和样本量的异质性限制了这些结果的可推广性。
虽然声带休息似乎能增强声带手术后的恢复和主观嗓音质量，但目前的证据基础仍不足以将声带休息确立为术后护理的决定性组成部分。需要开展更大规模的多中心随机对照试验，以阐明声带休息在声带伤口愈合中的作用，并制定基于证据的指南。
