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Title page for ETD etd-03222015-142421


Type of Document Master's Thesis
Author King, Renee Elizabeth
Author's Email Address reneekingslp@gmail.com
URN etd-03222015-142421
Title Outcomes of Voice Rest after Microflap Surgery for Benign Vocal Fold Lesions
Degree Master of Science
Department Hearing and Speech Sciences
Advisory Committee
Advisor Name Title
Bernard Rousseau, Ph.D., CCC-SLP Committee Chair
Michael de Riesthal, Ph.D., CCC-SLP Committee Member
Thomas Cleveland, Ph.D. Committee Member
Keywords
  • voice rest
  • voice therapy
  • postoperative outcomes
  • quality of life
Date of Defense 2015-03-13
Availability unrestricted
Abstract
Background/Purpose:

Research evidence regarding the efficacy of voice rest after microflap excision of benign vocal fold lesions is limited. This both results from and contributes to a lack of agreed-upon practice patterns regarding voice rest among physicians. Patients report decreased quality of life during voice rest. Basic science findings increasingly support vocal fold mobilization after the inflammatory phase of healing (3-5 days postoperatively). The purpose of the present study was to determine if longer durations of postoperative voice rest were associated with improved postsurgical outcomes.

Methods:

Retrospective chart review of 74 patients (mean age of 43 years; 53% male, 47% female) who underwent direct microlaryngoscopy with microflap surgery to remove a nodule, polyp, or cyst between June 1, 2009 and May 31, 2014. Outcomes were measured by changes in total Voice Handicap Index (VHI) score and by changes in the stroboscopic parameters mucosal wave and closure.

Results:

VHI scores improved by an average of 22.5 points after microflap surgery and voice rest. No statistically significant associations between prescribed or actual duration of voice rest and postsurgical outcomes were found. Patients who completed more preoperative voice therapy sessions were statistically more likely to complete more postoperative therapy sessions and to experience less improvement in VHI scores after surgery. Females completed more therapy sessions and experienced less improvement in VHI severity than males.

Conclusions:

Microflap surgery is an effective treatment of benign vocal fold lesions. The efficacy of postoperative voice rest is still unknown and warrants a well-designed prospective study. Pre- and postoperative voice therapy, adherence, gender, and age may be relevant to patient outcomes.

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