Scripties UMCG - Rijksuniversiteit Groningen
 
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Investigating voice outcomes after treating benign mid-membranous vocal fold lesions using a validated stratification system

(2017) Boogaard, J.J.A.

Background: Interpretation of treatment outcomes of voice disorders following benign midmembranous
vocal fold lesions (BMVFLs) is difficult since a standardized nomenclature
system is lacking. The aim of this study was to investigate outcomes of patients with
BMVFLs using a previously validated stratification system, while also providing incidences
and outcome results for each diagnosis.
Methods: A retrospective chart review of BMVFL patients was performed at the University
of Pittsburgh Medical Center from January 2009 to June 2014. Patients ≥ 18 years of age and
a primary diagnosis of BMVFL were included. Treatment typically involved implementation
of nonsurgical therapy followed by phonomicrosurgery. A previously reported BMVFL
nomenclature system for stratification of lesions was used. Statistical analysis included
descriptive analysis, paired sampled t-test and Wilcoxon signed-rank test.
Results: Initially 251 patients with BMVFLs were studied, whereof 224 were included in this
study of which 150 patients underwent phonomicrosurgery. In the included study group the
most common BMFVL types were polyp (30.8%), non-specific vocal fold lesions (NSVFL,
24.1%) and fibrous mass-subepithelial (FB-SE, 21.4%). Pseudocyst represented 0.9% of the
cohort. Significant p values were demonstrated with the Voice Handicap Index-10 (VHI-10)
and acoustic data. Average change in VHI-10 was greatest for polyp, cyst–subepithelial, and
FB-SEs. Fibrous mass–ligamentous patients showed the smallest mean change in VHI-10.
Average post-treatment VHI-10 scores of all the lesions were within normal limits (<11)
except for fibrous mass–ligamentous lesions.
Conclusions: 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. This study represents the
first outcomes-based report of BMVFLs using a strictly defined stratification system of
BMVFL lesions.






 
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