Phonosurgery of vocal fold polyps, cysts and nodules is beneficial

Dan Med J. 2013 Feb;60(2):A4577.

Abstract

Introduction: This study reports our experience with microscopic phonosurgery (PS) of benign lesions of the vocal folds.

Material and methods: During the five-year period from 2003 to 2007, a total of 97 patients had PS for vocal fold polyps (n = 63), vocal fold cysts (n = 17), vocal fold nodules (n = 12) or vocal fold oedema (n = 5). Their average age was 41 years; 62% were women and 69% were smokers. Post-operative voice therapy was given to 45 patients. Post-operative clinical evaluation was available for data analysis in 89 patients (92%). Voice quality was assessed using the Multi-Dimensional Voice Program (MDVP), video-stroboscopy and self-reported assessment. The median follow-up time was 3.9 months.

Results: Post-operative voice quality was reported as unaffected in 85%, improved but moderately affected in 13%, and severely affected in one patient with a cyst and vocal fold sulcus. Unaffected voice quality was obtained in 91% of patients not receiving voice therapy and in 77% of patients receiving voice therapy. All lesions except one polyp in the anterior commissure were completely removed. MDVP was performed both pre- and post-operatively in 22% of patients. The effect was a significant improvement of jitter (p = 0.013), shimmer (p = 0.001) and Soft Phonation Index (p = 0.013).

Conclusion: PS is a quick and effective treatment with uncommon and transient post-operative complications. Objective assessment of the voice pre- and post-operatively should be used consistently and applied in controlled studies evaluating the additional impact of pre- and post-operative voice therapy.

Funding: not relevant.

Trial registration: not relevant.

MeSH terms

  • Adult
  • Cysts / rehabilitation
  • Cysts / surgery*
  • Edema / surgery*
  • Female
  • Humans
  • Laryngeal Diseases / rehabilitation
  • Laryngeal Diseases / surgery*
  • Male
  • Microsurgery
  • Phonation
  • Polyps / rehabilitation
  • Polyps / surgery*
  • Postoperative Period
  • Preoperative Period
  • Smoking
  • Voice Quality*
  • Voice Training