Our Summary

The study focuses on how accurately and consistently doctors can grade the movement of the vocal cords using a method called flexible nasendoscopy (FNE). The process involves looking at the vocal cords through a special tube inserted in the nose. The researchers used 30 videos of this procedure, without sound or patient background information, and had six experienced surgeons watch and grade the vocal cord movement. They used two different grading scales: one with five categories and one with three categories. They found that the doctors agreed with each other’s ratings about 67.7% of the time using the five-category scale and about 91.4% of the time using the three-category scale. The doctors also agreed with their own ratings about 78.3% of the time using the five-category scale and about 93.1% of the time using the three-category scale. The study concludes that it’s hard for doctors to consistently grade small differences in vocal cord movement and suggests the need for a more objective measurement method.

FAQs

  1. What is flexible nasendoscopy (FNE) and how is it used in the study?
  2. What were the results of the study regarding the consistency of doctors grading the movement of the vocal cords?
  3. Why does the study suggest the need for a more objective measurement method for grading vocal cord movement?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vocal cord surgery is to follow post-operative care instructions closely to ensure proper healing and recovery. This may include voice rest, avoiding straining the vocal cords, staying hydrated, and attending follow-up appointments for monitoring progress. It is important to communicate any concerns or symptoms to the doctor during the recovery process.

Suitable For

Patients who may be recommended vocal cord surgery include those with:

  1. Vocal cord paralysis: This can be caused by nerve damage, injury, or other underlying medical conditions. Surgery may be recommended to improve vocal cord function and restore voice quality.

  2. Vocal cord nodules or polyps: These are benign growths on the vocal cords that can cause hoarseness and difficulty speaking. Surgery may be recommended to remove these growths and improve vocal cord function.

  3. Vocal cord cancer: Surgery may be recommended to remove cancerous growths on the vocal cords and surrounding tissues.

  4. Vocal cord trauma: In cases of severe vocal cord injury, surgery may be recommended to repair or reconstruct the damaged vocal cords.

  5. Vocal cord dysfunction: This condition can cause difficulty breathing, coughing, and voice changes. Surgery may be recommended to correct any structural abnormalities in the vocal cords.

Overall, the decision to recommend vocal cord surgery depends on the specific condition and needs of the individual patient. It is important to consult with a healthcare provider or specialist to determine the most appropriate treatment plan.

Timeline

Before vocal cord surgery, a patient may experience symptoms such as hoarseness, difficulty speaking or singing, a weak voice, and vocal fatigue. They may also undergo various tests such as laryngoscopy and imaging studies to determine the cause of their vocal cord dysfunction.

After vocal cord surgery, a patient may initially experience throat pain, hoarseness, and difficulty swallowing. They will need to rest their voice and follow specific post-operative care instructions provided by their surgeon. Over time, as the vocal cords heal, the patient’s voice should gradually improve, and they may undergo speech therapy to help with vocal rehabilitation. The ultimate goal of vocal cord surgery is to improve voice quality and function for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vocal cord surgery include:

  1. What specific type of vocal cord surgery do you recommend for my condition?
  2. What are the risks and potential complications associated with the surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Will I need to undergo any additional tests or evaluations before the surgery?
  5. How many of these surgeries have you performed, and what is your success rate?
  6. What are the potential long-term effects or outcomes of the surgery?
  7. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  8. What can I expect in terms of voice quality and function after the surgery?
  9. How soon can I expect to see improvements in my voice after the surgery?
  10. Are there any lifestyle changes or precautions I should take post-surgery to optimize my recovery?

Reference

Authors: Douglas CM, Menon R, Montgomery J, Townsley R, Hilmi O, Buchanan MA, Robertson S, Petropoulakis L, Soraghan JJ, Lakany H, Mackenzie K. Journal: Ann R Coll Surg Engl. 2024 Jan;106(1):36-40. doi: 10.1308/rcsann.2022.0091. Epub 2022 Oct 20. PMID: 36263913