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Keywords:

  • Dysphonia;
  • vocal fold nodules;
  • Voice Handicap Index;
  • phonosurgery

Objectives/Hypothesis

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.

Study Design

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.

Level of Evidence

2b (Individual retrospective cohort study). Laryngoscope, 123:1926–1930, 2013