Current practices for voice rest recommendations after phonomicrosurgery

Joshi, Ashwini; Johns, Michael M.

doi:10.1002/lary.26979

Cited by 24 publications

(26 citation statements)

References 20 publications

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“…The benefit of voice rest following an injury remains a subject of debate, since a considerable number of factors contribute to the healing process leading to inconclusive results [17,57]. Kaneko et al investigated the role of voice rest based on vocal and laryngoscopic/stroboscopic parameters.…”

Section: In Vivo Studiesmentioning

confidence: 99%

In vitro mechanical vibration down-regulates pro-inflammatory and pro-fibrotic signaling in human vocal fold fibroblasts

et al. 2020

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Introduction Voice rest following phonotrauma or phonosurgery has a considerable clinical impact, but clinical recommendations are inconsistent due to inconclusive data. As biopsies of the vocal folds (VF) for molecular biology studies in humans are unethical, we established a new in vitro model to explore the effects of vibration on human vocal fold fibroblasts (hVFF) in an inflammatory and normal state, which is based on previously published models. Methods By using a phonomimetic bioreactor we were able to apply predefined vibrational stress patterns on hVFF cultured under inflammatory or normal conditions. Inflammatory and pro-fibrotic stimuli were induced by interleukin (IL)1β and transforming growth factor (TGF)β1, respectively. Mechanical stimulation was applied four hours daily, over a period of 72 hours. Outcome measurements comprised assessment of extracellular matrix (ECM)-related components, angiogenic factors, and inflammatory and fibrogenic markers on gene expression and protein levels. Results Under inflammatory conditions, the inflammatory cytokine IL11, as well as the myofibroblast marker alpha smooth muscle actin (α-SMA) were significantly reduced when additional vibration was applied. The desirable anti-fibrotic ECM component hyaluronic acid was increased following cytokine treatment, but was not diminished following vibration. Conclusion Our experiments revealed the effect of vibrational stress on hVFF in an inflammatory state. Elevated levels of certain pro-inflammatory/pro-fibrotic factors could be mitigated by additional vibrational excitation in an in vitro setting. These findings corroborate clinical studies which recommend early voice activation following an acute event.

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Section: In Vivo Studiesmentioning

confidence: 99%

In vitro mechanical vibration down-regulates pro-inflammatory and pro-fibrotic signaling in human vocal fold fibroblasts

et al. 2020

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“…In contrast, a European survey of surgeons showed the most common length of voice rest prescribed was 1 to 2 days, with variability depending on the type of vocal fold pathology . A more recent survey of laryngologists shows that surgeons employ a combination of complete and relative voice rest …”

Section: Introductionmentioning

confidence: 98%

“…Several survey studies highlight the heterogeneity of postoperative voice care instructions given to patients . A 2003 survey of American Academy of Otolaryngology members reported 7 days of voice rest was most commonly prescribed, albeit with a considerable discrepancy in responses ranging from 0 to 28 days .…”

Section: Introductionmentioning

confidence: 99%

Role of voice rest following laser resection of vocal fold lesions: A randomized controlled trial

et al. 2019

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Objectives/Hypothesis Voice rest is often prescribed following phonosurgery by most surgeons despite limited empiric evidence to support its practice. This study assessed the effect of postphonosurgery voice rest on vocal outcomes. Study Design Prospective, randomized controlled trial. Methods Patients with unilateral vocal fold lesions undergoing CO2 laser excision were recruited in a prospective manner and randomized into one of two groups: 1) an experimental arm consisting of 7 days of absolute voice rest, or 2) a control arm consisting of no voice rest. The primary outcome measure was the Voice Handicap Index‐10 (VHI‐10) questionnaire. Secondary outcomes included aerodynamic measurements (maximum phonation time), acoustic measures (fundamental frequency, jitter, shimmer, and harmonic‐to‐noise ratio), and auditory‐perceptual measures. Primary and secondary outcomes were assessed preoperatively and reassessed postoperatively at the 1‐ and 3‐month follow‐up. Patient compliance to voice rest instructions were controlled for using subjective and objective parameters. Results Thirty patients were enrolled with 15 randomized to each arm of the study. Statistical analysis for the entire cohort showed a significant improvement in the mean preoperative VHI‐10 compared to postoperative assessments at 1‐month (19.0 vs. 7.3, P < .05) and 3‐month (19.0 vs. 6.2, P < .05) follow‐up. However, between‐group comparisons showed no significant difference in postoperative VHI‐10 at either time point. Similarly, secondary outcome measures yielded no significant difference in between‐group comparisons. Conclusions Our study shows no significant benefit to voice rest on postoperative voice outcomes as determined by patient self‐perception, acoustic variables, and auditory‐perceptual analysis. Level of Evidence 1b Clinical Trial Number NCT02788435 (http://clinicaltrials.gov) Laryngoscope, 130:1750–1755, 2020

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“…En una investigación realizada por Joshi et al, (2018) que tenía como objetivo conocer los protocolos actuales implementados por los laringólogos inmediatamente despues de la fonomicrocirugía de lesiones benignas en los pliegues vocales. Fue observado que los laringólogos indicaban a sus pacientes 7 días de reposo vocal pos-microcirugía laríngea de nódulos vocales, quiste en ppvv, pólipo vocal y edema de Reinke y de 1 a 4 días para leucoplasia y papiloma laríngeo y 8 días de reposo vocal relativo para todas las patologías vocales, posterior al reposo vocal absoluto.…”

Section: Fonoaudiólogo Clínica Los Nogales Bogotá-colômbiaunclassified

“…La importancia del reposo vocal, evitando la producción de voz entre las 48 -72 horas despues de la microcirugía de laringe, se debe a que se puede perjudicar la cicatrización, debido a la ausencia de fibroblastos, lo cual incrementa la inflamación del ppvv. Por lo tanto, una recuperación incompleta, puede interrumpir el proceso de cicatrización del tejido, lo que puede ocasionar reducción en la elasticidad y tener efecto en las características de la calidad de la voz en los pacientes (Joshi et al, 2018).…”

Section: Fonoaudiólogo Clínica Los Nogales Bogotá-colômbiaunclassified

II Jornada de actualización en Fonoaudiología

Rojas¹,

Alves²,

Ricz³

et al. 2021

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La ii Jornada de actualización en Fonoaudiología: Abordaje clínico interdisciplinario de la deglución y la voz se celebró el 26 y 27 de octubre de 2020, organizada por el Programa de Fonoaudiología de la Escuela de Medicina de Ciencias de Salud, fue desarrollada en el marco de una convocatoria institucional interna Beca Virtual Exchange de la Universidad del Rosario, que tiene como objetivo convocar a comunidades académicas y compartir experiencias desde diferentes regiones nacionales e internacionales, en este tiempo de la pandemia a nivel mundial. El objetivo de la ii Jornada de actualización en Fonoaudiología: Abordaje clínico interdisciplinario de la deglución y la voz fue crear un espacio colaborativo de aprendizaje entre los profesores del Programa de Fonoaudiología de la Universidad del Rosario y la Facultad de Medicina de Ribeirão Preto de la Universidade de São Paulo – Brasil, quienes participaron como coorganizadores en esta ii Jornada de actualización en Fonoaudiología, promoviendo la práctica basada en la evidencia por medio del intercambio de conocimientos entre los fonoaudiólogos y profesionales de ciencias de la salud de la comunidad rosarista y de diferentes lugares de Colombia y el mundo. ii Jornada de actualización en Fonoaudiología: Abordaje clínico interdisciplinario de la deglución y la voz, tuvo una variedad de temáticas, que fueron exploradas en las diferentes conferencias y que fueron resumidas por los siete conferencistas invitados en estas memorias.

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Current practices for voice rest recommendations after phonomicrosurgery

Abstract: 4. Laryngoscope, 128:1170-1175, 2018.

Cited by 24 publications

References 20 publications

In vitro mechanical vibration down-regulates pro-inflammatory and pro-fibrotic signaling in human vocal fold fibroblasts

In vitro mechanical vibration down-regulates pro-inflammatory and pro-fibrotic signaling in human vocal fold fibroblasts

Role of voice rest following laser resection of vocal fold lesions: A randomized controlled trial

II Jornada de actualización en Fonoaudiología

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