Compliance and Quality of Life in Patients on Voice Rest

Abstract

and associated lesions. 2) Provide pre-and postoperative data on perceptive, acoustic and aerodynamic voice parameters. METHOD: We retrospectively reviewed the charts of patients treated in our department between 1998 and 2008 for sulcus vocalis and related lesions using the CO2-laser assisted endoscopic surgery with digital scanning, based on the technique described by Cornut and Bouchayer, and intraoperative collagen injection when vocal atrophy was present. Epidemiological data, perceptive, acoustic and aerodynamic parameters were collected at the preoperative and last follow-up visits and statistical analysis performed with the Wilcoxon signed rank test. RESULTS: There were 42 patients with a mean age of 41 years. Twenty-three patients had sulcus vocalis and nineteen had epidermoid vocal fold cysts. Seventeen patients had bilateral lesions. Collagen was injected for 9 patients. We observed a statistically significant improvement in the grade, roughness, and breathiness of the perceptual analysis according to Hiranos scale (G preϭ2,G postϭ1, pϭ0.003) (R preϭ2, R postϭ0, pϭ0.0020) (B preϭ1, B postϭ0, pϭ0.003), in the Voice Handicap Index Score (VHI preϭ53, VHI postϭ36, pϭ0.001). The maximal phonation time, phonatory quotient, jitter and frequency range were improved without reaching statistical significance. CONCLUSION: The CO2-laser scanning system seems a reliable option for the treatment of sulcus vocalis and related lesions based on perceptive and subjective data; however the objective improvement is harder to prove because surgery improves the vocal effort but does not induce normal looking and functioning vocal folds.

The clinical utility of vocal dosimetry for assessing voice rest

“…A meaningful study of voice rest would necessitate compliance with recommended parameters during that period of time. Rousseau et al have described relatively low self‐reported “complete compliance” of 35% among patients who were prescribed voice rest . An additional 44% reported that they “almost never” used their voice.…”