Efficacy of Voice Therapy For Vocal Fold Masses: Avoidance of Surgery

Objective: Voice abuse and misuse are the main causes of benign vocal fold mass lesions. Masses can be treated by surgical resection, voice therapy, or a combination of both. However, voice therapy may be an effective method to resolve vocal fold masses or manage symptoms and thus avoid the need for surgical intervention. Over the last few decades, specialists have advocated for routine pre-operative voice therapy, as well as post-operative therapy. Current evidence regarding the effectiveness of voice therapy is scarce and controversial due to vocal fold mass nomenclature disagreements, techniques of diagnosis, and lack of controlled studies.

Methods: Five hundred medical charts of patients who were with diagnosed with benign vocal fold masses were reviewed. Variables such as voice therapy data, smoking history, occupation, vocal fold pathology, and others, were collected. Surgically treated patients who underwent pre-operative voice therapy were included and matched to non-surgical voice therapy patients to determine whether their voice therapy and compliance thereof, and the nature of their masses, were comparable. Raters reviewed strobovideolaryngoscopy of the non-surgical patients, analyzing lesions and determining whether, lesions improved over time.

Researchers performed analysis to determine the relationship between the voice therapy used and the rate of improvement of benign vocal fold masses, subdivided by type of lesion. Researchers also performed secondary analysis to determine if patients receiving voice therapy could avoid vocal fold surgery or not, and to determine variables associated with progression to voice surgery. Data from the raters will determine accuracy of determining lesions and improvement relative to chart diagnoses as well as to each other.

Results and Conclusions: