Phonomicrosurgery in Vocal Fold Nodules: Quantification of Outcomes in Professional and Non-Professional Voice Users

Abstract

These results confirm that phonomicrosurgery for VFN is a safe therapy for voice improvement in both PVU and NVU who do not respond to voice therapy alone. Top-level artistic capabilities in PVU were restored, but numeric changes of most vocal parameters were considerably larger in NVU.

Efficacy of Phonosurgery, Logopedic Voice Treatment and Vocal Pedagogy in Common Voice Problems of Singers

“…The recently introduced parameter, VEM, demonstrated significant changes with phonosurgery, logopedic treatment and vocal pedagogy in all singers. This confirmed the results of previous studies where the VEM proved to be a comprehensible and easy-to-use measure for objective evaluation of the VRP [19,45]. The standardized VRP and the data thereby determined in order to calculate the DSI are core elements in objective voice diagnostics [67].…”

“…In organic dysphonia, our study showed that conservative therapy might also be helpful in singers with small marginal edema, but seems not to be effective for restitution of other chronic findings such as keratinized vocal fold nodules or persistent contact granuloma. Our phonosurgical treatment indication and results are in line with published research data concluding that phonomicrosurgical resection is an adequate therapy to improve the voice in singers suffering from chronic benign glottal lesions [19,42]. Comparable to the subgroup of operated patients in our investigation, Zeitels et al [40] prospectively studied the outcome in 185 singers and performing artists who underwent phonomicrosurgical excision of different vocal fold lesions.…”

“…The DiVAS software (XION Medical) was used for standardized registration of the voice range profile (VRP) and acoustic-aerodynamic analyses to obtain objective quantitative measurements of the speaking and singing voice [19,48]. Various parameters were recorded, such as lowest vocalization (I_min), highest tone (F 0 _max), maximum phonation time (MPT) and Jitter.…”

“…They are usually broad-based and appear in the middle third of the membranous part of the vocal folds, the region in which the amplitude has its maximum during phonation [17,18]. The findings contain different entities, ranging from soft swellings without fibrous duplication of the underlying stroma to hard keratinized nodules [19]. Polyps appear in most cases unilaterally at the free margin of the vocal folds [20].…”

“…Surgery is indicated in persisting organic lesions with impaired artistic capabilities, if non-surgical methods prove to be ineffective [40][41][42]. However, there are few data regarding the specific extent to which different modalities of conservative and surgical interventions improve vocal function [19].…”