Long‐term results of surgical treatment of vocal fold nodules

Béquignon, E.; Bach, C.; Fugain, C; Guilleré, L.; Blumen, M.; Chabolle, F.; Wagner, I.

doi:10.1002/lary.23768

Cited by 40 publications

(24 citation statements)

References 27 publications

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“…In addition, long classroom hours, large student numbers and also high noise level in classroom are reported as common factors resulting in vocal fold nodules among teachers . Clinically, vocal fold nodules can be treated with laryngeal microsurgery, but the high recurrence rate of post‐operative dysphonia was considered associated with the absence of voice therapy,The above observations and the results of the present study imply that abnormal vocal responses to auditory interference may at least partially contribute to the development of vocal fold nodules, and the power spectral analysis of F0 provided an objective method for measuring the audio‐vocal interactions.…”

Section: Discussionsupporting

confidence: 54%

Vocal fold nodules: A disorder of phonation organs or auditory feedback?

Lee

Fang

et al. 2019

Clinical Otolaryngology

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Objective Increasing evidence supports that auditory feedback of one's own voice closely relates to real‐time adjustments of vocal control. Previous studies highlighted that the low‐frequency modulations of below 3 Hz (LFM) embedded in vocal fundamental frequency (F0) showed a reflex‐like response to altered auditory inputs. However, the auditory feedback control of different vocal disorders remains unclear. Design A cross‐sectional, case‐controlled study. Setting A tertiary medical centre. Participants Sustained vocalisations of vowel/a/ from adult healthy controls and patients with vocal fold nodules, vocal fold polyps and vocal fold cysts, respectively. The vocalisations were made at a comfortable pitch and at the intensity of 70 ~ 80 dBC under the following four auditory conditions: natural hearing, 90‐dBC speech noise, 10‐dBC enhanced feedback of self‐produced voice and both the noise and voice feedback. Main outcome measures Power spectral analysis of F0 contour of sustained vowel. Results Patients with vocal fold nodules presented with different audio‐vocal feedback behaviour and audio‐vocal response to speech noise from the other two vocal pathologies of vocal fold polyp and vocal fold cyst as well as the healthy controls (P < .001, one‐way ANOVA). Conclusion The vocal fold nodules may be not only a vocal fold disease but also a disease caused by abnormal audio‐vocal feedback. Moreover, the distinct audio‐vocal feedback of vocal fold nodules could be revealed by power spectral analysis of vocal fundamental frequencies. Although further investigations are necessary, adjustments of audio‐vocal feedback behaviour may provide a new insight and benefit to the treatment of vocal fold nodules in the future.

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Section: Discussionsupporting

confidence: 54%

Vocal fold nodules: A disorder of phonation organs or auditory feedback?

Lee

Fang

et al. 2019

Clinical Otolaryngology

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“…Current treatment options for phonotraumatic vocal fold pathologies include conservative voice therapy and surgery 10,13 . In rare cases when surgery is the recommended option when conservative voice therapy fails, it is not difficult to understand that many patients would look for alternative treatment options because of the invasiveness and risk associated with surgery.…”

Section: Discussionmentioning

confidence: 99%

“…It is not difficult to understand that some individuals may find the invasiveness of surgery and the extended period required for behavioral change not a viable option for them. Furthermore, it is noted as much as 10-20% of patients with dysphonia did not improve with such treatment régime at all 13-15 .…”

Section: Introductionmentioning

confidence: 97%

“…Contemporary treatment recommendations include behavioral voice therapy that aims to re-adjust voicing mechanics and allows the vocal pathologies to resolve through a wound healing process is the current treatment option 7,8 . Surgery may be needed in some recalcitrant cases 9-11 but follow-up behavioral voice therapy 12,13 is required. It is not difficult to understand that some individuals may find the invasiveness of surgery and the extended period required for behavioral change not a viable option for them.…”

Section: Introductionmentioning

confidence: 99%

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Is Acupuncture Efficacious for Treating Phonotraumatic Vocal Pathologies? A Randomized Control Trial

et al. 2016

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Objective To investigate the effectiveness of acupuncture in treating phonotraumatic vocal fold lesions. Study Design/Methods A total of 123 dysphonic individuals with benign vocal pathologies were recruited. They were given either genuine acupuncture (N=40), sham acupuncture (N=44) or a no-treatment (N=39) for six weeks (two 30-minute sessions per week). The genuine acupuncture group received needles puncturing nine voice-related acupoints for 30 minutes, two times a week for six weeks; while the sham acupuncture group received blunted needles stimulating the skin surface of the nine acupoints for the same frequency and duration. The no-treatment group did not receive any intervention but attended just the assessment sessions. One hundred and seventeen subjects completed the study (genuine acupuncture=40; sham acupuncture=43, and no-treatment=34), but only 84 of them had a complete set of vocal functions and quality of life measures (genuine acupuncture=29; sham acupuncture=33, and no-treatment=22), and 42 of them with a complete set of endoscopic data (genuine acupuncture=16; sham acupuncture=15 and no-treatment=11). Results Significant improvement in vocal function, as indicated by the maximum fundamental frequency produced, and also perceived quality of life, were found in both the genuine and sham acupuncture groups, but not in the no-treatment group. Structural (morphological) improvements were, however, only noticed in the genuine acupuncture group, which demonstrated a significant reduction in the size of the vocal fold lesions. Conclusions The findings showed that acupuncture of voice-related acupoints could bring about improvement in vocal function and healing of vocal fold lesions.

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“…Benign vocal fold pathologies, such as vocal nodules, polyps, or chronic (noninfectious) laryngitis, are common causes of voice problems that resulted from trauma to vocal fold tissue during phonation (phonotrauma) . Current treatment options generally include conservative behavioral voice therapy that allows the vocal pathologies to resolve through a wound‐healing process, occasionally requiring surgery in some chronic conditions, and supplemented by vocal hygiene education and behavioral voice therapy …”

Section: Introductionmentioning

confidence: 99%

Wound‐healing effect of acupuncture for treating phonotraumatic vocal pathologies: A cytokine study

Yiu¹,

Chan²,

et al. 2015

The Laryngoscope

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Objective Acupuncture is a less invasive procedure when compared with surgical treatment for benign vocal pathologies caused by vocal overuse. This study aimed to determine the wound healing effect of acupuncture in treating phonotraumatic vocal fold lesions. Study Design and Methods The study used a two-way mixed-model between- and within-subjects, prospective randomized, placebo-controlled, blinded, group design. Seventeen dysphonic individuals with vocal nodules were recruited from a university clinic in Hong Kong. Each participant was randomly assigned to receive one session of either genuine or sham acupuncture. The genuine acupuncture group (N=9) received needles puncturing nine voice-related acupoints for 30 minutes; while the sham acupuncture group (N=8) received blunted needles stimulating the skin surface of the nine acupoints for the same frequency and duration. Laryngeal secretions were suctioned from the surface of the vocal folds immediately before, immediately after, and 24 hours after the acupuncture. The protein concentration levels of wound-healing related cytokines (interlukin IL-1 and IL-10) in these secretion samples were measured. Results Following acupuncture, a significant increased in the anti-inflammatory cytokine IL-10 was found in the genuine acupuncture group (N=9) but not in the sham acupuncture group (N=8). Conclusions The findings showed that acupuncture of voice-related acupoints facilitated an anti-inflammatory process in phonotraumatic vocal pathologies. This could be considered as supporting evidence to consider acupuncture as a less invasive alternative option, when compared to surgery, for treating phonotraumatic vocal pathologies.

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Long‐term results of surgical treatment of vocal fold nodules

Abstract: Postoperative voice therapy decreases the risk of recurrence. Vocal fold nodules can recur over a period of 5 years, consequently requiring follow-up for at least 5 years in clinical practice and in future prospective studies.

Cited by 40 publications

References 27 publications

Vocal fold nodules: A disorder of phonation organs or auditory feedback?

Vocal fold nodules: A disorder of phonation organs or auditory feedback?

Is Acupuncture Efficacious for Treating Phonotraumatic Vocal Pathologies? A Randomized Control Trial

Wound‐healing effect of acupuncture for treating phonotraumatic vocal pathologies: A cytokine study

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