TY - JOUR
T1 - "Cold-Steel" Phonosurgery of Reinke Edema Evaluated by the Multidimensional Voice Program
AU - Schyberg, Ylva Margareta
AU - Bork, Kristian Hveysel
AU - Sørensen, Martin Kryspin
AU - Rasmussen, Niels
PY - 2018/3
Y1 - 2018/3
N2 - OBJECTIVES: "Cold-steel" phonosurgery (PS) of Reinke edema is challenging, as the delicate structures of the vocal folds are difficult to preserve. This study aimed to evaluate the results of PS using the Multidimensional Voice Program (MDVP) .MATERIALS AND METHODS: From 2003 to 2007, 76 consecutive patients with Reinke edema were treated with PS for the first time. Reliable MDVP data were available in 37 female patients with both pre- and postoperative values in 14 patients. Voice quality and outcome after PS were evaluated by jitter, shimmer, soft phonation index, and fundamental frequency (f0) using MDVP, videostroboscopy, and a five-step voice outcome score.RESULTS: In the 14 patients, the mean f0 increased from 172 to 222 (P = 0.01), and jitter decreased from 2.03 to 1.17 (P = 0.04) 3 months postoperatively. Vocal fold grading based on videostroboscopy correlated significantly with jitter (P = 0.01). Patients with high preoperative values of jitter, shimmer, or soft phonation index had larger reductions than those with normal values. All had a postoperative reduction of the edemas. The mean voice outcome score increased postoperatively. None of the 37 patients reported complications, but seven patients were reoperated. Preoperatively, 95% of the 37 patients were smokers and only 9 (24%) changed smoking habits. Pre- or postoperative voice therapy was used in 23 (62%) patients.CONCLUSIONS: f0 and jitter by MDVP adequately reflected the postoperative voice improvement and reduction of the edema. Removal of large amounts of edematous tissue, many years of vocal abuse, and unchanged smoking habits may prevent optimal results.
AB - OBJECTIVES: "Cold-steel" phonosurgery (PS) of Reinke edema is challenging, as the delicate structures of the vocal folds are difficult to preserve. This study aimed to evaluate the results of PS using the Multidimensional Voice Program (MDVP) .MATERIALS AND METHODS: From 2003 to 2007, 76 consecutive patients with Reinke edema were treated with PS for the first time. Reliable MDVP data were available in 37 female patients with both pre- and postoperative values in 14 patients. Voice quality and outcome after PS were evaluated by jitter, shimmer, soft phonation index, and fundamental frequency (f0) using MDVP, videostroboscopy, and a five-step voice outcome score.RESULTS: In the 14 patients, the mean f0 increased from 172 to 222 (P = 0.01), and jitter decreased from 2.03 to 1.17 (P = 0.04) 3 months postoperatively. Vocal fold grading based on videostroboscopy correlated significantly with jitter (P = 0.01). Patients with high preoperative values of jitter, shimmer, or soft phonation index had larger reductions than those with normal values. All had a postoperative reduction of the edemas. The mean voice outcome score increased postoperatively. None of the 37 patients reported complications, but seven patients were reoperated. Preoperatively, 95% of the 37 patients were smokers and only 9 (24%) changed smoking habits. Pre- or postoperative voice therapy was used in 23 (62%) patients.CONCLUSIONS: f0 and jitter by MDVP adequately reflected the postoperative voice improvement and reduction of the edema. Removal of large amounts of edematous tissue, many years of vocal abuse, and unchanged smoking habits may prevent optimal results.
KW - Acoustics
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Female
KW - Humans
KW - Laryngeal Edema/diagnosis
KW - Laryngoscopy/adverse effects
KW - Microsurgery/adverse effects
KW - Middle Aged
KW - Phonation
KW - Recovery of Function
KW - Retrospective Studies
KW - Risk Factors
KW - Severity of Illness Index
KW - Smoking/adverse effects
KW - Stroboscopy
KW - Surgical Flaps
KW - Time Factors
KW - Treatment Outcome
KW - Video Recording
KW - Vocal Cords/pathology
KW - Voice Quality
U2 - 10.1016/j.jvoice.2017.04.020
DO - 10.1016/j.jvoice.2017.04.020
M3 - Journal article
C2 - 28596099
SN - 0892-1997
VL - 32
SP - 244
EP - 248
JO - Journal of Voice
JF - Journal of Voice
IS - 2
ER -