Voice Rest Does Not Impact Laser Resection Results for Superficial Vocal Cord Lesions

by Linda Kossoff •

Does a prescription of voice rest have a meaningful impact on vocal outcomes following CO2 laser resection of superficial vocal cord lesions?

Bottom Line: Voice rest had no significant effect on postoperative voice outcomes following CO2 laser resection of vocal cord lesion.

Background: Surgeons prescribe voice rest following vocal fold surgery under the supposition that mucosal healing is optimized under resting conditions, leading to enhanced voice function recovery; however, a paucity of available clinical data has resulted in a wide spectrum of clinical practice that lacks a strong evidence-based foundation.

Study Design: Prospective, randomized controlled trial as determined by patient self-perception, acoustic variables, and auditory-perceptual analysis.

Setting: Western University, London, Ontario, Canada.

Synopsis: Thirty adult patients were enrolled and randomized into two study arms of 15 patients. All patients underwent CO2 laser resection for unilateral vocal fold lesions, performed by a single surgeon at a tertiary academic center. Postoperatively, the experimental arm was prescribed absolute voice rest for seven days; the control group was prescribed no postoperative voice rest. To control for compliance, patients were instructed to wear a vocal dosimeter for one week following surgery. Assessments, which were obtained at four and 12 weeks, included several validated questionnaires and voice samples. Data were analyzed to compare subjective and objective measurements for patients prior to surgery preoperatively and at both assessment points. The entire cohort showed significant improvement at one- and three-month follow-ups; between-group comparisons failed to show any significant difference at either of the time points. Authors note that results are limited to some extent by patient subjectivity and the inability to wear the dosimeter at all times. Also, because this patient population received CO2 laser resections, findings are not applicable to other types of deeper resections.

Citation: Dhaliwal SS, Doyle PC, Failla S, et al. Role of voice rest following laser resection of vocal fold lesions: a randomized controlled trial. Laryngoscope. 2020;130:1750-1755.