title: Long-term results of surgical treatment of vocal fold nodules.
abstract: OBJECTIVE
  To evaluate the long-term outcome of patients with vocal fold nodules treated by surgery alone, or by a combination of surgery and voice therapy and to identify factors associated with long-term recurrent dysphonia.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  All patients who had undergone surgery for vocal fold nodules in a tertiary care hospital between 1996 and 2006 were contacted. After giving their consent, they were evaluated by videostroboscopic examination of vocal fold nodules and by a subjective questionnaire including the Voice Handicap Index (VHI).
  
  
  RESULTS
  Sixty-two out of 90 patients (69%) (60 women, 2 men with a mean age of 33 years) answered the questionnaire at a mean interval of 9.5 years after surgery. Recurrent dysphonia was observed in 19 patients (30%) at a mean interval of 5.2 years after surgery and new benign vocal fold lesions (nodules or Reinke's edema) were observed in 11 patients (18%). Absence of postoperative voice therapy was significantly associated with a higher recurrence rate (P = 0.02) (56% of recurrent dysphonia without voice therapy versus 22% with voice therapy).
  
  
  CONCLUSIONS
  Postoperative voice therapy decreases the risk of recurrence. Vocal fold nodules can recur over a period of 5 years, consequently requiring follow-up for at least 5 years in clinical practice and in future prospective studies.
authors.affiliation: Department of Oto-Rhino-Laryngology and Reconstructive Cervicofacial Surgery, Hopital Foch 40 Rue Worth, 92150, Suresnes, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Béquignon
authors.forename: Christine
authors.initials: C
authors.lastname: Bach
authors.forename: Claude
authors.initials: C
authors.lastname: Fugain
authors.forename: Lia
authors.initials: L
authors.lastname: Guilleré
authors.forename: Marc
authors.initials: M
authors.lastname: Blumen
authors.forename: Frédéric
authors.initials: F
authors.lastname: Chabolle
authors.forename: Isabelle
authors.initials: I
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods*; D055154:Dysphonia / Q000209:etiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014827:Vocal Cords / Q000473:pathology* / Q000601:surgery; D014832:Voice Disorders / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014833:Voice Quality; D055815:Young Adult
keywords: Dysphonia; Voice Handicap Index; phonosurgery; vocal fold nodules