title: Optimal Duration for Voice Rest After Vocal Fold Surgery: Randomized Controlled Clinical Study.
abstract: OBJECTIVE
  Voice rest is commonly recommended after phonomicrosurgery to prevent worsening of vocal fold injuries. However, the most effective duration of voice rest is unknown. Recently, early vocal stimulation was recommended as a means to improve wound healing. The purpose of this study is to examine the optimal duration of voice rest after phonomicrosurgery.
  
  
  METHODS
  Randomized controlled clinical study.
  
  
  METHODS
  Patients undergoing phonomicrosurgery for leukoplakia, carcinoma in situ, vocal fold polyp, Reinke's edema, and cyst were chosen. Participants were randomly assigned to voice rest for 3 or 7 postoperative days. Voice therapy was administered to both groups after voice rest. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and postoperatively at 1, 3, and 6 months. Stroboscopic examination evaluated normalized mucosal wave amplitude (NMWA). Parameters were compared between both groups.
  
  
  RESULTS
  Thirty-one patients were analyzed (3-day group, n = 16; 7-day group, n = 15). Jitter, shimmer, and VHI-10 were significantly better in the 3-day group at 1 month post operation. GRBAS was significantly better in the 3-day group at 1 and 3 months post operation, and NMWA was significantly better in the 3-day group at 1, 3, and 6 months post operation compared to the 7-day group.
  
  
  CONCLUSIONS
  The data suggest that 3 days of voice rest followed by voice therapy may lead to better wound healing of the vocal fold compared to 7 days of voice rest. Appropriate mechanical stimulation during early stages of vocal fold wound healing may lead to favorable functional recovery.
authors: Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Mami
authors: M
authors: Kaneko
authors: Department of Communication Sciences and Disorders, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan.
authors: Osamu
authors: O
authors: Shiromoto
authors: Department of Eating Disorder and Dysphagia, the University of Niigata Rehabilitation Graduate School, Niigata, Japan.
authors: Masako
authors: M
authors: Fujiu-Kurachi
authors: Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Yo
authors: Y
authors: Kishimoto
authors: Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Ichiro
authors: I
authors: Tateya
authors: Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. Electronic address: hirano@ent.kuhp.kyoto-u.ac.jp.
authors: Shigeru
authors: S
authors: Hirano
mesh_terms: D000162:Acoustics; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007564:Japan; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010699:Phonation; D011446:Prospective Studies; D020127:Recovery of Function; D049489:Stroboscopy; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014827:Vocal Cords / Q000503:physiopathology / Q000601:surgery*; D014832:Voice Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014833:Voice Quality; D014834:Voice Training; D014945:Wound Healing; D055815:Young Adult
keywords: Fibroblast; Phonomicrosurgery; Stimulation; Voice rest; Voice therapy