Assessment of pre and postoperative voice quality in cases of vocal fold polyp

Sachana Prasad; Ranjan Raychowdhury; Amitabha Roychoudhury

doi:10.18203/issn.2454-5929.ijohns20200150

Authors

Sachana Prasad Department of Otorhinolaryngology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
Ranjan Raychowdhury Department of Otorhinolaryngology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India
Amitabha Roychoudhury Department of Otorhinolaryngology, Vivekananda Institute of Medical Sciences, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20200150

Keywords:

Vocal fold polyp, Phonomicrosurgery, Voice quality, Stroboscopy

Abstract

Background: Benign vocal fold lesions comprise of a wide range of conditions resulting from vocal misuse or abuse (vocal nodules, polyps, cysts etc.), acute and chronic inflammatory changes, congenital vocal fold anomalies, vocal fold trauma and benign tumours. It results in significant impairment of vocal communication with major psychosocial impact.

Methods: The prospective study was conducted in Department of Otolaryngology, Vivekananda Institute of Medical Sciences, Kolkata from January 2016 to January 2018. All forty patients diagnosed with vocal fold polyp underwent phonomicrosurgery using micro-flap technique followed by voice therapy. Detailed pre-operative and post-operative (3 weeks, 6 weeks, 12 weeks follow up) voice assessment including fibre optic laryngoscopy and laryngovideo-stroboscopic findings were recorded.

Results: Voice quality of the 40 patients with vocal fold polyps who underwent cold steel phonomicrosurgery had a statistically significant improvement at each follow up visit (3 weeks, 6 weeks and 12 weeks) as assessed by the subjective variables of voice handicap index score, visual analogue scale score and grade, roughness, breathiness, asthenia, strain score and objective variables of jitter, shimmer, harmonic-to-noise ratio, maximum phonation time and fibreoptic laryngoscopy and videolaryngostroboscopic findings. Fundamental frequency in females had statistically improved results but in males, though there was an improvement, the values were not statistically significant.

Conclusions: Cold steel microlaryngeal surgery using micro-flap technique offers excellent results in patients with vocal fold polyps. Perceptual, aerodynamic, acoustic, self-analysis and videolaryngostroboscopic parameters together allow multidimensional assessment of voice characteristics.

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References

Hirano M. Morphological structure of the vocal cord as a vibrator and its variations. Folia Phoniatr (Basel). 1974;26(2):89-94.

Jacobson BH, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger MS, Newman C. The Voice Handicap Index (VHI): Development and Validation. American Journal of Speech-Language Pathology 1997;6:66-70.

Rosen CA, Lee AS, Osborne J, Zullo T, Murry T. Development and validation of the voice handicap index‐10. The Laryngoscope. 2004;114(9):1549-56.

Hirano M. Clinical Examination of the Voice. Vienna: Springer- Verlag; 1981.

Julian Mc Glashan, Adrian Fourcin Objective analysis of Voice. Scott Brown Head Neck Surg. 2008;7(2):2170-92.

Von Leden H. The history of phonosurgery. New York: Raven Press Ltd; 1991.

Sataloff RT, Spiegel JR, Heuer RJ, Baroody MM, Emerich KA, Hawkshaw MJ, et al. Laryngeal mini-microflap: a new technique and reassessment of the microflap saga. J Voice. 1995;9(2):198-204.

Wallis L, Jackson-Menaldi C, Holland W, Giraldo A. Vocal fold nodule vs. vocal fold polyp: answer from surgical pathologist and voice pathologist point of view. J Voice. 2004;18(1):125-9.

Simpson B, Rosen C. Pathological Conditions of the Vocal Fold. Operative Techniques Laryngol. 2008: 21-8.

Nagata K, Kurita S, Yasumoto S, Maeda T, Kawasaki H, Hirano M. Vocal fold polyps and nodules. A 10-year review of 1,156 patients. Auris Nasus Larynx. 1983;10:27-35.

Lin L, Sun N, Yang Q, Zhang Y, Shen J, Shi L, et al. Effect of voice training in the voice rehabilitation of patients with vocal cord polyps after surgery. Experimental Therap Med. 2014;7(4):877-80.

Schindler A, Mozzanica F, Ginocchio D, Maruzzi P, Atac M, Ottaviani F. Vocal improvement after voice therapy in the treatment of benign vocal fold lesions. Acta Otorhinolaryngologica Italica. 2012;32(5):304.

Salmen T, Ermakova T, Möller A, Seipelt M, Weikert S, Rummich J, et al. The value of vocal extent measure (VEM) assessing phonomicrosurgical outcomes in vocal fold polyps. J Voice. 2017;31(1):114-7.

Akbulut S, Gartner‐Schmidt JL, Gillespie AI, Young VN, Smith LJ, Rosen CA. Voice outcomes following treatment of benign midmembranous vocal fold lesions using a nomenclature paradigm. The Laryngoscope. 2016;126(2):415-20.

Rosen CA, Murry T, Zinn A, Zullo T, Sonbolian M. Voice handicap index change following treatment of voice disorders. J Voice. 2000;14(4):619-23.

Štajner‐Katušić S, Horga D, Zrinski KV. A longitudinal study of voice before and after phonosurgery for removal of a polyp. Clin linguistics Phonetics. 2008;22(10-11):857-63.

Thomas G, Mathews SS, Chrysolyte SB, Rupa V. Outcome analysis of benign vocal cord lesions by videostroboscopy, acoustic analysis and voice handicap index. Indian J Otolaryngol Head Neck Surg. 2007;59(4):336-40.

Ragab SM, Elsheikh MN, Saafan ME. Radiophonosurgery of benign superficial vocal fold lesions.J Laryngol Otol. 2005;119:961-6.

Virmani N, Sharma A, Dabholkar JP. Outcome analysis in patients with benign vocal fold lesions. Int J Phonosurg Laryngol. 2016;6(1):8-13.

Uloza V, Saferis V, Uloziene I. Perceptual and acoustic assessment of voice pathology and the efficacy of endolaryngeal phonomicrosurgery. J Voice. 2005;19(1):138-45.

Petrović-Lazić M, Babac S, Vuković M, Kosanović R, Ivanković Z. Acoustic voice analysis of patients with vocal fold polyp. J Voice. 2011;25(1):94-7.

Phaniendra Kumar V,Srinivas Murthy M,Ravikanth S,Kumar R.Phonomicrosurgery for benign vocal fold lesions-our experience.Indian J Otolaryngol Head Neck Surg. 2003;55(3):184-6.

Toran S, Lal BK. Objective voice analysis for vocal polyps following microlaryngeal phonosurgery. Kathmandu Univ Med J. 2010;8(2):185-9.

Zeitels SM, Hillman RE, Mauri M, Desloge R, Doyle PB. Phonomicrosurgery in singers and performing artists: treatment outcomes, management theories, and future directions. Annals Otol Rhinol Laryngo. 2002;111(12):21-40.

Cohen SM, Garrett CG. Utility of voice therapy in the management of vocal fold polyps and cysts. Otolaryngol Head Neck Surg. 2007;136(5):742-6.

Jensen JB, Rasmussen N. Phonosurgery of vocal fold polyps, cysts and nodules is beneficial. Dan Med J. 2013;60(2):4577.