Optimal Duration for Voice Rest After Vocal Fold Surgery: Randomized Controlled Clinical Study

Kaneko, Mitsuaki; Shiromoto, Osamu; Fujiu-Kurachi, Masako; Kishimoto, Yo; Tateya, Ichiro; Hirano, Shigeru

doi:10.1016/j.jvoice.2016.02.009

Cited by 56 publications

(61 citation statements)

References 45 publications

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“…Our study is in line with other published works showing an emerging trend favoring a movement away from absolute or complete voice rest postoperatively . To date, three clinical trials have been performed examining short‐ versus long‐term voice rest of 3 versus 7 days, 5 versus 10 days, or 0 versus 7 days .…”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

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

et al. 2019

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“…The vocal fold vibratory amplitude was defined by subtracting d1 from d2 and was normalized by dividing this value by the membranous vocal fold length (L). The vocal fold vibratory amplitude = (d2−d1)/L (arbitrary units; Kaneko et al, ). Vocal fold vibratory amplitude was measured by a laryngologist (Y. K.) and a speech language pathologist (M. K.) independently in a blinded fashion in which neither rater was given any information about the images such as step number and time point.…”

Section: Methodsmentioning

confidence: 99%

A phase I/II exploratory clinical trial for intracordal injection of recombinant hepatocyte growth factor for vocal fold scar and sulcus

Hirano

Kawamoto

Tateya

et al. 2017

J Tissue Eng Regen Med

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Vocal fold scar and sulcus are intractable diseases with no effective established treatments. Hepatocyte growth factor (HGF) has preclinically proven to have potent antifibrotic and regenerative effects on vocal fold scar. The current Phase I/II clinical trial aims to examine the safety and effectiveness of intracordal injection of a recombinant human HGF drug for patients with vocal fold scar or sulcus. This is an open-label, dose-escalating, first-in-human clinical trial. Eighteen patients with bilateral vocal fold scar or sulcus were enrolled and divided into three groups: Step I received 1 μg of HGF per vocal fold; Step II received 3 μg of HGF; and Step III received 10 μg of HGF. Injections were administered once weekly for 4 weeks. The protocol treatment was performed starting with Step I and escalating to Step III. Patients were followed for 6 months post-treatment. Local and systemic safety aspects were examined as primary endpoints, and therapeutic effects were assessed as secondary endpoints using voice handicap index-10; maximum phonation time; vocal fold vibratory amplitude; grade, rough, breathy, asthenic, strained scale; and jitter. The results indicated no serious drug-related adverse events in either the systemic or local examinations. In whole-subject analysis, voice handicap index-10, vocal fold vibratory amplitude, and grade, rough, breathy, asthenic, strained scale were significantly improved at 6 months, whereas maximum phonation time and jitter varied. There were no significant differences in phonatory data between the step groups. In conclusion, intracordal injection of a recombinant human HGF drug was safe, feasible, and potentially effective for human patients with vocal fold scar or sulcus.

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“…The integrity of the layers of the vocal folds, especially of the cover of the vocal folds, is vital for good voice quality. We currently lack a complete understanding of the wound healing process of the vocal fold tissues . Significant headway has been made in the basic sciences on examining tissue recovery at the cellular level, but at this time, our clinical recommendations to maximize tissue pliability after phonosurgery are based on a small number of studies and anecdotal evidence …”

Section: Introductionmentioning

confidence: 99%

“…We currently lack a complete understanding of the wound healing process of the vocal fold tissues. 1 Significant headway has been made in the basic sciences on examining tissue recovery at the cellular level, 2-6 but at this time, our clinical recommendations to maximize tissue pliability after phonosurgery are based on a small number of studies and anecdotal evidence. 1,7,8 Approximately 11% of patients diagnosed with dysphonia have a benign lesion as the primary etiology.…”

Section: Introductionmentioning

confidence: 99%

“…1 Significant headway has been made in the basic sciences on examining tissue recovery at the cellular level, 2-6 but at this time, our clinical recommendations to maximize tissue pliability after phonosurgery are based on a small number of studies and anecdotal evidence. 1,7,8 Approximately 11% of patients diagnosed with dysphonia have a benign lesion as the primary etiology. 9 A combination of surgical and behavioral therapy is utilized to minimize scarring that may result from iatrogenic trauma to the mucosa of the vocal folds or from unrestrained voice use.…”

Section: Introductionmentioning

confidence: 99%

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Current practices for voice rest recommendations after phonomicrosurgery

Joshi

Johns

2017

The Laryngoscope

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Optimal Duration for Voice Rest After Vocal Fold Surgery: Randomized Controlled Clinical Study

Cited by 56 publications

References 45 publications

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

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

A phase I/II exploratory clinical trial for intracordal injection of recombinant hepatocyte growth factor for vocal fold scar and sulcus

Current practices for voice rest recommendations after phonomicrosurgery

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