RESUMEN

Benign vocal fold lesions (BVFLs) are acquired structural anomalies of the vocal folds, and these are primarily a result of vocal abuse or phonotrauma. Phonotraumatic lesions are not generally regarded as recurrent, provided that appropriate behavioral changes are made after resolution or surgical removal. Voice therapy plays a crucial role in this aspect. The aim of this article is to propose a structured pre- and post-operative voice therapy program for patients undergoing surgical intervention for BVFLs. Voice therapy post-surgery has been proven to reduce the rate of recurrence in BVFLs. Having a standard treatment protocol is a useful tool for the therapist, particularly one without extensive voice training.

Las lesiones benignas de los pliegues vocales (LBPV) son anomalías estructurales adquiridas de los pliegues vocales, y son principalmente el resultado de un abuso vocal o fonotrauma. Las lesiones fonotraumáticas generalmente no se consideran recurrentes, siempre que se realicen cambios apropiados en el comportamiento después de la resolución o la excisión quirúrgica. La terapia vocal juega un papel crucial en este aspecto. El objetivo de este artículo es proponer un programa estructurado de terapia de voz pre y postoperatorio para pacientes que son expuestos a una intervención quirúrgica para LBPV. Se ha demostrado que la terapia de voz después de la cirugía reduce la tasa de recurrencia en LBPV. Tener un protocolo de tratamiento estándar es una herramienta útil para el terapeuta, particularmente uno sin un entrenamiento extenso en patología de la voz.

RESUMEN

OBJECTIVES: To describe our experience in diagnosis, evaluation, management and evolution of adult patients diagnosed with vocal fold hemorrhage (VFH) in the Voice Unit at Universidad Católica Clinical Hospital Santiago, Chile. STUDY DESIGN: Retrospective chart review. METHODS: Adult patients diagnosed with VFH between 2012 and 2020 were included. Demographic data, medical and vocal history, vocal symptoms and questionnaires, laryngeal videostroboscopy, treatment, and follow-up controls were reviewed. RESULTS: A total of 34 patients were included, 52.9% (18) patients were female and 47.1% (16) male. Mean age was 42 years (22-76 years) and 47.1% were professional voice users. Principal voice symptoms were dysphonia (32/34), vocal fatigue (21/34) and throat clearing (17/34). Twenty-six (76.5%) patients had VFH and a concomitant lesion in the same vocal fold (VF), being a hemorrhagic polyp the most prevalent associated lesion (61.8%). All patients were managed initially with voice rest, showing improvement at first follow up visit according to VRQOL-STD (mean difference -32.43, P = 0.009) and VHI-10 (mean difference 11.22, P = 0.036), and laryngeal videostroboscopic resolution in 66.7% (8/12) at a mean 12.5 (range 6-30) days. CONCLUSIONS: VFH is an infrequent phonotraumatic condition. More studies are needed to advance in knowledge of this pathology as there is contradictory evidence in the literature regarding predisposing factors, evolution and prognosis of this condition.