Microscopic Phonosurgery in Benign Vocal Fold Lesions

Abstract

Abstract Introduction : Although Phonosurgery has been the mainstay of treatment for benign vocal fold lesions for decades, advanced diagnostic modalities improved techniques of voice therapy and vocal hygiene have helped managing them in a more precise and better way. Objective : To study the role of phonomicrosurgery in benign vocal fold lesions. Methods : This prospective study was under taken in a tertiary health care centre for a period of one-year (October 2012) to September 2013, thirty two patients had undergone phonosurgery for vocal fold polyps (n = 14), vocal fold cysts (n=8), vocal fold nodules(n=3), Sulcus vocalis (n=2), vocal fold papilloma (n=l), vocal fold angioma (n=l), keratotic patch (n=2) and vocal fold oedema (n=1). Their average age was 41 years of which 62% werewomenand 69% were smokers. Postoperative voice therapy was given to sixteen patients. Post-operative clinical evaluation was available for data analysis in 30 patients (92%). Voice quality was assessed using the voice handicap index-10 questionaire (VHI-10), direct laryngoscopy was performed pre & post-operatively and self-reported assessment. The median follow-up time was 4 months. Result : Thirty out of 32 patients showed objective improvement in fibreoptic laryngoscopy post treatment. Two patients were noncompliant to voice therapy and showed recurrence of their pathologies.Mean VHI 10 score showed significant improvement from 8 in the preoperative period to 3 in the postoperative period. Conclusion : Phonosurgery is a quick and effective treatment with uncommon and transient post-operative complications. Pre and postoperative voice therapy plays an integral role in combination with phono-micro surgery enhances the outcome in patients with benign vocal fold lesions. Objective assessment of the voice pre- and postoperatively should be used consistently to evaluate the additional impact of pre- and postoperative voice therapy.

Keywords

• Laryngeal diseases, Vocal Cords