Absolute or relative voice rest after phonosurgery

Abstract

Objectives: Voice rest is commonly recommended after phonomicrosurgery to prevent worsening of vocal fold injuries. According to the literature, voice rest following phonosurgery, as recommended in clinical practice, varies between 3 and 7 days. The most effective duration of voice rest is unknown. Before early vocal stimulation was recommended as a means to improve wound healing. The purpose of this study is to examine the optimal duration of voice rest after phonomicrosurgery. Study design: Preliminary randomized prospective blind clinical trial. Methods: Patients undergoing phonomicrosurgery for leukoplakia, carcinoma in situ, vocal fold polyp, Reinke's edema, and cyst were chosen. Participants were randomly assigned to voice rest for 3 or 7 postoperative days. Voice therapy was administered to both groups after voice rest. Grade, roughness, breathiness, and strain (GRBAS) scale, stroboscopic examination (NMVA) and Voice Handicap Index‐10 (VHI‐10) were performed pre‐ and postoperatively at 1, 3, and 6 months. Parameters were compared between both groups. Results: Thirty patients were analyzed (3‐day group, n = 18; 7‐day group, n = 12). Jitter, shimmer, and VHI‐10 were significantly better in the 3‐day group at 1 month post operation. GRBAS was significantly better in the 3‐day group at 1 and 3 months post operation, and NMWA was significantly better in the 3‐day group at 1, 3, and 6 months post operation compared to the 7‐day group. Conclusions: We suggest that 3 days of voice rest followed by voice therapy may lead to better wound healing of the vocal fold compared to 7 days of voice rest.