title: Voice outcomes following treatment of benign midmembranous vocal fold lesions using a nomenclature paradigm.
abstract: OBJECTIVE
  Benign midmembranous vocal fold lesions (BMVFLs) are common voice disorders, but interpretation of outcomes following treatment is difficult due to the lack of a standardized nomenclature system for these lesions. Outcome results are increasingly important to third party payers. This study aimed to investigate the outcomes of patients with BMVFLs using a previously validated nomenclature, and to provide incidences and outcome results for each diagnosis.
  
  
  METHODS
  A retrospective chart review of BMVFL patients was performed. Treatment was individualized but typically involved implementation of nonsurgical therapy followed by phonomicrosurgery as needed. A previously reported BMVFL stratification system was used.
  
  
  RESULTS
  A total of 224 patients with BMVFLs were studied. Sixty-seven percent of all patients with a BMVFL underwent phonomicrosurgery. The most common BMVFL types were polyp and nonspecific vocal fold lesion. Pseudocyst represented 0.9% of the cohort. The Voice Handicap Index-10 (VHI-10) and acoustic data demonstrate a high degree of treatment success. The mean change in VHI-10 was greatest for cyst-subepithelial and polyp. Fibrous mass-ligamentous patients had the smallest mean change in VHI-10. Mean post-treatment VHI-10 scores of all the lesions except fibrous mass-ligamentous were within normal limits (<11).
  
  
  CONCLUSIONS
  This study represents the first outcomes-based report of BMVFLs using a strictly defined nomenclature system for stratification of lesions. Ligamentous fibrous mass lesions have a decreased response to treatment compared to all other lesions. This study demonstrates the ability to return most BMVFL patients to normal speaking voice capabilities following treatment.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, Lutfi Kirdar Research Hospital, Istanbul, Turkey.
authors.forename: Sevtap
authors.initials: S
authors.lastname: Akbulut
authors.affiliation: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Gartner-Schmidt
authors.affiliation: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Amanda I
authors.initials: AI
authors.lastname: Gillespie
authors.affiliation: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: VyVy N
authors.initials: VN
authors.lastname: Young
authors.affiliation: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Libby J
authors.initials: LJ
authors.lastname: Smith
authors.affiliation: University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D009626:Terminology as Topic; D014827:Vocal Cords / Q000473:pathology / Q000503:physiopathology*; D014833:Voice Quality; D014834:Voice Training
keywords: Vocal cord lesions; nomenclature; speech therapy; vocal cord polyp; vocal nodules