Effect of voice therapy on vocal fold polyp treatment

  • Mustafa Sahin
  • Sercan Gode
  • Murat Dogan
  • Tayfun Kirazli
  • Fatih Ogut
Laryngology

Abstract

Purpose

To investigate the role of voice therapy (VT) and factors that may affect the response to VT in the treatment of vocal fold polyps, especially as a complement to phonosurgery.

Methods

Retrospective review of patients with vocal fold polyp undergoing surgery and/or VT in a tertiary medical center. The demographic data, phoniatric history, videolaryngostroboscopic findings, polyp characteristics, VHI-10 and GRB scores, and voice analysis data were recorded before and after the treatment. The patients were grouped as those who had undergone endolaryngeal microsurgery only (Group S), those who had first received VT then undergone surgery due to inadequate VT outcome (Group VTpS), and those who had only undergone VT with a follow-up plan (Group VT).

Results

Data were reviewed from 211 (108 M, 103 F) patients with a mean age of 41.3 ± 11 years. The improvement in all voice-related variables observed in the S and VTpS groups was significantly greater compared to the VT group despite the degree of improvement achieved in this group. At the end of the treatment period, improvements in G-R-B, VHI-10 and stroboscopy scores were significantly greater in the VTpS group than in the S and VT groups.

Conclusion

Voice therapy can improve voice quality to some extent during the treatment of vocal fold polyps. However, VT alone is unsatisfactory compared to surgery alone. Pre-surgical VT can enhance the ultimate success of treatment. A young age, small polyps, and short duration of dysphonia may increase the possibility of benefiting from VT.

Keywords

Vocal fold Polyp Voice therapy Surgery Voice analysis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human rights

For this type of retrospective study, formal consent is not required.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Johns MM (2003) Update on the etiology, diagnosis, and treatment of vocal fold nodules, polyps, and cysts. Curr Opin Otolaryngol Head Neck Surg 11:456–461CrossRefPubMedGoogle Scholar
  2. 2.
    Martins RH, Defaveri J, Domingues MA, de Albuquerque e Silva R (2011) Vocal polyps: clinical, morphological, and immunohistochemical aspects. J Voice 25(1):98–106.  https://doi.org/10.1016/j.jvoice.2009.05.002 (Epub 2010 Jan 25) CrossRefPubMedGoogle Scholar
  3. 3.
    Nunes RB, Behlau M, Nunes MB, Paulino JG (2013) Clinical diagnosis and histologic alanalysis of vocal nodules and polyps. Braz J Otorhinolaryngol 79(4):434–440CrossRefPubMedGoogle Scholar
  4. 4.
    Filho JM, Carvalho B, Mizoguchi FM, Catani GS, Filho ED, Malafaia O, Stahlke HJ Jr (2013) Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx. Int Arch Otorhinolaryngol 17(3):279–284CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Cohen SM, Dupont WD, Courey MS (2006) Quality-of-life impact of nonneoplastic voice disorders: a meta-analysis. Ann Otol Rhinol Laryngol 115:128–134CrossRefPubMedGoogle Scholar
  6. 6.
    Barillari MR, Volpe U, Mirra G, Giugliano F, Barillari U (2017) Surgery or rehabilitation: a randomized clinical trial comparing the treatment of vocal fold polyps via phonosurgery and traditional voice therapy with “voice therapy expulsion”. Train J Voice 31(3):379.e13–379.e20.  https://doi.org/10.1016/j.jvoice.2016.07.002 CrossRefGoogle Scholar
  7. 7.
    Sulica L, Behrman A (2003) Management of benign vocal fold lesions: a survey of current opinion and practice. Ann Otol Rhinol Laryngol 112:827–833CrossRefPubMedGoogle Scholar
  8. 8.
    Yun YS, Kim MB, Son YI (2007) The effect of vocal hygiene education for patients with vocal polyp. Otol Head Neck Surg 137:569–575CrossRefGoogle Scholar
  9. 9.
    Cohen SM, Garrett CG (2007) Utility of voice therapy in the management of vocal fold polyps and cysts. Otol Head Neck Surg 136:742–746CrossRefGoogle Scholar
  10. 10.
    Nakagawa H, Miyamoto M, Kusuyama T, Mori Y, Fukuda H (2012) Resolution of vocal fold polyps with conservative treatment. J Voice 26(3):e107–e110.  https://doi.org/10.1016/j.jvoice.2011.07.005 CrossRefPubMedGoogle Scholar
  11. 11.
    Speyer R (2008) Effects of voicetherapy: a systematicreview. J Voice 22(5):565–580CrossRefPubMedGoogle Scholar
  12. 12.
    Lee YS, Lee DH, Jeong GE, Kim JW, Roh JL, Choi SH, Kim SY, Nam SY (2017) Treatment efficacy of voice therapy for vocal fold polyps and factors predictive of its efficacy. J Voice 31(1):120.e9–120.e13.  https://doi.org/10.1016/j.jvoice.2016.02.014 CrossRefGoogle Scholar
  13. 13.
    Cho KJ, Nam IC, Hwang YS, Shim MR, Park JO, Cho JH, Joo YH, Kim MS, Sun DI (2011) Analysis of factors influencing voice quality and therapeutic approaches in vocal polyp patients. Eur Arch Otorhinolaryngol 268:1321–1327CrossRefPubMedGoogle Scholar
  14. 14.
    Klein AM, Lehmann M, Hapner ER, Johns MM 3rd (2009) Spontaneous resolution of hemorrhagic polyps of the true vocal fold. J Voice 23:132–135CrossRefPubMedGoogle Scholar
  15. 15.
    Zhuge P, You H, Wang H, Zhang Y, Du H (2016) An analysis of theeffects of voice therapy on patients with earlyvocal fold polyps. J Voice 30(6):698–704CrossRefPubMedGoogle Scholar
  16. 16.
    Dejonckere PH, Bradley P, Clemente P, Cornut G, Crevier-Buchman L, Friedrich G, Van De Heyning P, Remacle M, Woisard V, Committee on Phoniatrics of the European Laryngological Society (ELS) (2001) A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques. Guideline elaborated by the Committee on Phoniatrics of the European Laryngological Society (ELS). Eur Arch Otorhinolaryngol 258:77–82CrossRefPubMedGoogle Scholar
  17. 17.
    Kilic MA, Okur E, Yildirim I, Oğüt F, Denizoglu I, Kizilay A, Oguz H, Kandogan T, Dogan M, Akdogan O, Bekiroglu N, Oztarakci H (2008) Reliability and validity of the Turkish Version of the Voice Handicap Index. Kulak Burun Bogaz IhtisDerg 18:139–147Google Scholar
  18. 18.
    Belafsky PC, Postma GN, Koufman JA (2002) Validity and reliability of the Reflux Symptom Index (RSI). J Voice 16:274–277CrossRefPubMedGoogle Scholar
  19. 19.
    Jeong WJ, Lee SJ, Lee WY, Chang H, Ahn SH (2014) Conservative management for vocal fold polyps. JAMA Otolaryngol Head Neck Surg 140:448–452CrossRefPubMedGoogle Scholar
  20. 20.
    Schindler A, Mozzanica F, Ginocchio D, Maruzzi P, Atac M, Ottaviani F (2012) Vocal improvement after voice therapy in the treatment of benign vocal fold lesions. Acta Otorhinolaryngol Ital 32:304–308PubMedPubMedCentralGoogle Scholar
  21. 21.
    Petrovic-Lazic M, Jovanovic N, Kulic M, Babac S, Jurisic V (2015) Acoustic and perceptual characteristics of the voice in patients with vocal polyps after surgery and voice therapy. J Voice 29:241–246CrossRefPubMedGoogle Scholar
  22. 22.
    Hochman II, Zeitels SM (2000) Phonomicrosurgical management of vocal fold polyps: the subepithelial microflap resection technique. J Voice 14:112–118CrossRefPubMedGoogle Scholar
  23. 23.
    Stajner-Katusić S, Horga D, Zrinski KV (2008) A longitudinal study of voice before and after phonosurgery for removal of a polyp. Clin Linguist Phon 22:857–863CrossRefPubMedGoogle Scholar
  24. 24.
    Lin L, Sun N, Yang Q et al (2014) Effect of voice training in the voice rehabilitation of patients with vocal cord polyps after surgery. Exp Ther Med 7:877–880CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Tang SS, Thibeault SL (2017) Timing of voice therapy: a primary investigation of voice outcomes for surgical benign vocal fold lesion patients. J Voice 31(1):129.e1–129.e7.  https://doi.org/10.1016/j.jvoice.2015.12.005 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OtorhinolaryngologyAdnan Menderes University Faculty of MedicineAydınTurkey
  2. 2.Department of OtolaryngologyEge University Medical SchoolIzmirTurkey

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