Presented at the 2013 Meeting of the American Laryngological Association, Orlando, Florida, U.S.A,, April 9–10, 2013.
Vocal fold pseudocyst: Results of 46 cases undergoing a uniform treatment algorithm
Article first published online: 13 NOV 2013
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.
Volume 124, Issue 5, pages 1180–1186, May 2014
How to Cite
Estes, C. and Sulica, L. (2014), Vocal fold pseudocyst: Results of 46 cases undergoing a uniform treatment algorithm. The Laryngoscope, 124: 1180–1186. doi: 10.1002/lary.24451
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 18 APR 2014
- Article first published online: 13 NOV 2013
- Accepted manuscript online: 1 OCT 2013 05:55AM EST
- Manuscript Accepted: 23 SEP 2013
- Manuscript Revised: 7 AUG 2013
- Manuscript Received: 18 FEB 2013
- voice disorder;
- vocal fold;
- vocal fold lesion;
- vocal fold paresis;
- vocal fold pseudocyst
To describe treatment results and identify predictors of the need for surgical intervention in patients with vocal fold pseudocyst.
Retrospective cohort study with longitudinal followup via survey.
Clinical records were reviewed for demographic information, VHI-10 score, and degree of severity of dysphonia. Videostroboscopic examinations were evaluated for presence of vocal fold pseudocyst, along with additional clinical variables, including laterality, reactive lesion, paresis, varix, and hemorrhage. Follow-up surveys were sent to all participants to evaluate current VHI-10 score and degree of vocal limitation. Results were analyzed to determine predictors of surgery and recurrence of pathology.
Forty-six patients (41F:5M) with pseudocyst (40 unilateral: 6 bilateral) were reviewed. Twenty-three (50%) had reactive lesions, nineteen (41%) had paresis by clinical criteria, 10 (22%) had varices, and 6 (13%) had hemorrhage on examination. All underwent initial behavioral management (2–12 sessions of voice therapy; mean of 8 sessions). Seventeen (37%) eventually required surgical intervention. No demographic or clinical variables proved predictive of surgical intervention. Follow-up surveys were completed by 63% of patients, and 79% agreed with the statement that they were not professionally limited by their voices.
This experience supports behavioral management as an initial intervention in patients with pseudocyst, sufficient by itself to restore vocal function in approximately two out of three patients. Neither initial severity nor any of the studied clinical findings predicted the need for surgery. The large majority of patients with pseudocyst are able to be treated effectively without impact in their professional function.
Level of Evidence
4 Laryngoscope, 124:1180–1186, 2014