Our Summary
This research paper studied how to best assess the results of surgical treatments for a condition called unilateral vocal fold paralysis (UVFP), where one side of the voice box doesn’t move properly. The researchers conducted a literature review to identify the most commonly used and effective measurement tools (voice outcome indicators, or VOIs) for comparing pre- and post-surgery results.
After reviewing the literature, eleven VOIs were identified. The most commonly used ones were: maximum phonation time (how long someone can sustain a sound), jitter (variation in pitch), shimmer (variation in loudness), video-stroboscopic examination (a video of the vocal folds), noise to harmonic ratio (a measure of voice quality), mean air flow (how much air flows through the vocal folds), and fundamental frequency (the lowest frequency of a sound).
The researchers then calculated the “percentage of significance” for each VOI, which represents how often a significant change was detected between pre- and post-surgery results using that VOI. The three VOIs with the highest percentages were maximum phonation time, mean air flow, and a measure from the GRBAS scale (a voice assessment tool).
In conclusion, these three VOIs appear to be the most useful for assessing the effectiveness of UVFP surgery. Some other commonly used VOIs, such as jitter and shimmer, had unclear roles. Others, like mean subglottic pressure (pressure beneath the vocal folds) and fundamental frequency, seemed to be less relevant.
FAQs
- What is unilateral vocal fold paralysis (UVFP) and how can it be treated?
- What are the most effective voice outcome indicators (VOIs) for assessing the results of UVFP surgery?
- What is the role of factors like jitter, shimmer, and fundamental frequency in assessing the results of vocal cord surgery?
Doctor’s Tip
Based on this research, a doctor might advise a patient undergoing vocal cord surgery to pay close attention to changes in their maximum phonation time, mean air flow, and GRBAS scale score as indicators of the success of the surgery. It’s important for patients to communicate any changes in their voice quality or ability to sustain sounds to their healthcare provider for proper assessment and monitoring of their vocal cord function post-surgery.
Suitable For
Patients with unilateral vocal fold paralysis (UVFP) are typically recommended vocal cord surgery if they experience symptoms such as hoarseness, breathiness, vocal fatigue, or difficulty swallowing. Surgery may be considered if conservative treatments such as voice therapy or injections into the vocal fold do not provide adequate improvement in voice quality or function. Additionally, patients who rely on their voice for their profession, such as singers or actors, may also be recommended for surgery to restore vocal function.
It is important for patients to undergo a thorough evaluation by an otolaryngologist (ear, nose, and throat specialist) to determine if they are a suitable candidate for vocal cord surgery. The decision to undergo surgery should be based on the severity of symptoms, the underlying cause of the vocal fold paralysis, and the potential benefits and risks of surgery. Additionally, patients should be informed about the potential outcomes of surgery and the need for post-operative voice therapy to optimize vocal function.
Timeline
Overall, the timeline for a patient before and after vocal cord surgery typically involves a period of pre-surgery evaluation and preparation, followed by the surgery itself and a period of recovery and rehabilitation.
Before surgery, the patient will undergo various assessments and tests to determine the extent of their vocal cord dysfunction and to ensure they are a suitable candidate for surgery. This may involve voice assessments, imaging studies, and consultations with a multidisciplinary team of specialists.
During the surgery, the patient will be under general anesthesia as the surgeon makes incisions to correct the vocal cord dysfunction. The specific procedure will depend on the underlying cause of the dysfunction, such as vocal cord paralysis or vocal nodules.
After surgery, the patient will need to rest their voice and follow specific guidelines for post-operative care, such as avoiding strenuous activities and refraining from speaking for a certain period of time. Speech therapy may also be recommended to help improve voice quality and function.
In the weeks and months following surgery, the patient will gradually regain strength in their voice as the vocal cords heal and adjust to the surgical changes. Regular follow-up appointments will be scheduled to monitor progress and assess the effectiveness of the surgery.
Overall, vocal cord surgery can be a life-changing procedure for patients with vocal cord dysfunction, helping to improve their voice quality and overall quality of life.
What to Ask Your Doctor
Some questions a patient should ask their doctor about vocal cord surgery include:
- What specific type of vocal cord surgery is recommended for my condition?
- What are the potential risks and complications associated with vocal cord surgery?
- What is the expected recovery time and process after vocal cord surgery?
- How will my voice quality and function be affected by the surgery?
- What kind of follow-up care and therapy will be needed after the surgery?
- What are the success rates of this surgery for treating my specific condition?
- What kind of voice outcome indicators will be used to assess the results of the surgery?
- How will the effectiveness of the surgery be measured in terms of improving my voice quality?
- Are there any alternative treatments or therapies that could be considered instead of surgery?
- Can you provide information about your experience and success rates with performing this type of vocal cord surgery?
Reference
Authors: Desuter G, Dedry M, Schaar B, van Lith-Bijl J, van Benthem PP, Sjögren EV. Journal: Eur Arch Otorhinolaryngol. 2018 Feb;275(2):459-468. doi: 10.1007/s00405-017-4844-9. Epub 2017 Dec 20. PMID: 29264655