Clinical Voice Outcomes for Two Voice Rest Protocols after Phonomicrosurgery.

OBJECTIVES: Voice rest is commonly recommended for patients with benign vocal fold lesions (BVFLs) after phonomicrosurgery. The study compares the clinical voice outcomes of two protocols, 7-day complete voice rest (CVR) and 3-day CVR followed by 4-day relative voice rest (CVR + RVR), for patients with BVFLs after phonomicrosurgery. STUDY DESIGN: Prospective, randomized controlled trial. METHOD: Patients with BVFLs undergoing phonomicrosurgery were recruited prospectively and randomly assigned to either protocol. Outcomes were assessed on objective measures of acoustics (fundamental frequency, frequency range, mean intensity, cepstral peak analysis) and aerodynamics (vital capacity, airflow rate, subglottal pressure, phonation threshold pressure), as well as subjective measures, both provider-reported through the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and patient-reported through the Voice Handicap Index (VHI). Clinical measures were collected at three-time points: preoperatively, 1-week postoperatively (on voice rest), and 1-month postoperatively. In addition, adherence was estimated using a vocal dosimeter. RESULTS: Twenty-five patients were recruited and randomized to 7-day CVR (n = 13) and CVR + RVR regimen (n = 12). Statistically significant changes were found within both groups for subglottal pressure (p = 0.03) and VHI score (p < 0.001) comparing pre-operative baseline to 1-month postoperative follow-up. There were no statistically significant differences between the groups. Regardless of group assignment, a significant decrease in overall severity ratings for the CAPE-V was found by comparing the preoperative scores to postoperative scores at 1-week (p < 0.001) and 1-month (p < 0.001). CONCLUSION: Both groups improved their overall voice quality comparably 1 month after undergoing phonomicrosurgery as measured by objective and subjective parameters. LEVELS OF EVIDENCE: 2. Laryngoscope, 134:2812-2818, 2024.

Exploring Personality and Perceived Present Control as Factors in Postsurgical Voice Rest: A Case Comparison.

OBJECTIVE: This case comparison explored the relation between personality, perceived present control, and postoperative voice rest (as estimated by self-report and objective voice use) following surgery for benign vocal fold lesions. METHOD: Two participants were included. Both participants were diagnosed with benign vocal fold pathology, underwent phonosurgery, and were assigned to either complete voice rest (CVR) or relative voice rest (RVR) postoperatively. During voice rest (VR), a visual analog scale (VAS) and a dosimeter (the Vocalog2) were used daily to estimate self-perceived and objective voice use, respectively. The participants also completed questionnaires on voice-related demographics, the Voice Handicap Index (VHI), Ten-Item Personality Inventory (TIPI), and Perceived Present Control (PPC). After 7 days of CVR or RVR, participants completed a postoperative questionnaire and a final VAS for overall voice use. RESULTS: A wide discrepancy was observed in one of two participant's subjective perception of voice use (using the VAS) versus objective dosimetry data wherein she reported significantly more voice use than was observed objectively. Differences in personality and PPC between the participants did not appear to affect their voice use following the VR protocols. CONCLUSION: The amount of voice use in both VR protocols for these two participants suggests that personality and PPC did not affect their adherence to recommendations of VR. Patients may perceive their voice use differently across time, which might play a role in their adherence to voice rest recommendations: voice use measured as instances versus a unit of time (seconds).

Suitability of English Language Internet-Based Information for Voice Disorders.

PURPOSE: The study was aimed at assessing the suitability of English-language Internet health information related to vocal hygiene, vocal health, and prevention of voice disorders. We also examined the relation between suitability, readability, and quality of Internet health information. METHOD: Suitability of 77 websites from Dueppen et al9 was assessed using the Suitability Assessment of Materials tool. Information about readability and quality of the websites were extracted from Dueppen et al.9 RESULTS: The overall converted suitability percent score of all 77 websites was 66.4%, which represents "adequate" suitability. Individual websites were rated as superior (ie, 44.2%) adequate (ie, 51.9%), and not suitable (ie, 3.9%). No relation was found between website origin and the suitability ratings. The inter-rater reliability of the Suitability Assessment of Materials ratings for overall scale was found to be good. The suitability of websites had a moderate correlation with readability measures, but no significant correlation was observed between the suitability and quality of websites. CONCLUSIONS: The study results suggest that overall suitability of websites on vocal hygiene are adequate. However, many websites may require improvements in some elements (eg, literacy demand, graphics, and learning stimulation). Readability, quality, and suitability are important components in the accessibility of health information for people with different health conditions. Hence, improvements in these elements are expected to improve the understanding and actionability of people with voice issues.

Quality and Readability of English-Language Internet Information for Voice Disorders.

PURPOSE: The purpose of this study is to evaluate the readability and quality of English-language Internet information related to vocal hygiene, vocal health, and prevention of voice disorders. This study extends recent work because it evaluates readability, content quality, and website origin across broader search criteria than previous studies evaluating online voice material. METHOD: Eighty-five websites were aggregated using five different country-specific search engines. Websites were then analyzed using quality and readability assessments. The entire web page was evaluated; however, no information or links beyond the first page was reviewed. Statistical calculations were employed to examine website ratings, differences between website origin and quality and readability scores, and correlations between readability instruments. RESULT: Websites exhibited acceptable quality as measured by the DISCERN. However, only one website obtained the Health On the Net certification. Significant differences in quality were found among website origin, with government websites receiving higher quality ratings. Approximate educational levels required to comprehend information on the websites ranged from 8 to 9 years of education. Significant differences were found between website origin and readability measures with higher levels of education required to understand information on websites of nonprofit organizations. CONCLUSION: Current vocal hygiene, vocal health, and prevention of voice disorders websites were found to exhibit acceptable levels of quality and readability. However, highly rated Internet information related to voice care should be made more accessible to voice clients through Health On the Net certification.