Voice rest after vocal fold surgery: current practice and evidence

Coombs, A C; Carswell, Anne; Tierney, Paul

doi:10.1017/s0022215113001485

Cited by 26 publications

(27 citation statements)

References 14 publications

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“…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%

“…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 . 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: 99%

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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: Introductionmentioning

confidence: 99%

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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“…Voice rest is one predictor of treatment outcome in patients undergoing vocal surgery [1]. There is, however, a lack of studies examining how microscopic changes to vocal fold tissue affect general vocal function [1] and the patients' general wellbeing [2] and there is still no standard protocol for providing voice rest advice [3]. A limited number of recent studies have provided clinical evidence for brief absolute voice rest (3-5 days) following surgery of benign lesions in the vocal folds [4,5], but few quantify differences between absolute and RVR [6].…”

Section: Introductionmentioning

confidence: 99%

Absolute or relative voice rest after phonosurgery: a blind randomized prospective clinical trial

Whitling

Åhlander

Rydell

2018

Logopedics Phoniatrics Vocology

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“…In der Literatur lässt sich vielfach die Auffassung finden, dass Flüstern schädlich sei [6,17]. Obwohl allgemein anerkannt ist, dass es beim Flüstern nicht zu Schwingungen der Stimmlippen kommt, wird von manchen Autoren vermutet, dass Luftstromturbulenzen oder eine vermehrte muskuläre Anspannung die Stimmlippen schädigen.…”

Section: Empfehlungen Und Untersuchungen Zum Flüsternunclassified

“…Obwohl allgemein anerkannt ist, dass es beim Flüstern nicht zu Schwingungen der Stimmlippen kommt, wird von manchen Autoren vermutet, dass Luftstromturbulenzen oder eine vermehrte muskuläre Anspannung die Stimmlippen schädigen. In den Empfehlungen, was Patienten postoperativ vermeiden sollen, wird Flüstern gleich nach Rufen und Singen genannt [6]. Andere Autoren fanden keinen möglichen schädlichen Mechanismus bei ihren Untersuchungen zum Flüstern [18].…”

Section: Empfehlungen Und Untersuchungen Zum Flüsternunclassified

Muss der Patient nach einer Stimmlippenoperation wirklich schweigen?

Fleischer

Heß

2019

Sprache Stimme Gehör

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After vocal fold surgery it is common to recommend voice rest for a certain time. The recommendations whether this should be complete voice rest or relative voice rest as well as the recommendations how long voice rest should be as well as whether whispering should be allowed, are diverse. There are some publications on these questions, mostly based on questionnaires, that demonstrate that there are a lot of different recommendations, but only few controlled studies on this topic. In this article the authors give an overview of the literature and their own recommendations, based on experience with phonosurgery and postoperative findings. Their recommendation for patients after vocal fold surgery is that they are allowed to whisper (soft whispering) immediately after the operation. Depending on the operation technique the authors recommend relative voice rest for 3???5 days and instruct patients to do voice exercises (soft glissando with closed mouth) after the 3?rd day. To their opinion, most harm could be done by coughing and throat clearing, which should be strictly avoided.

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Voice rest after vocal fold surgery: current practice and evidence

Abstract: There is a lack of consistency in advice given to patients after vocal fold surgery, in terms of both type and length of voice rest. This may arise from an absence of robust evidence on which to base practice.

Cited by 26 publications

References 14 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

Absolute or relative voice rest after phonosurgery: a blind randomized prospective clinical trial

Muss der Patient nach einer Stimmlippenoperation wirklich schweigen?

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