A follow-up study of surgically managed benign vocal cord lesions using vocal handicap index - 10 score.

Abstract

Benign lesions of the vocal cords not only impair the patient's ability to communicate due to poor pronunciation and voice capabilities, but they also cause a variety of psychological and social problems, worsening their quality of life. To assess voice handicap, Voice Handicap Index (VHI)-10 is an easy-to-administer, valid and reliable tool. The present study was conducted to compare the pre-operative and post-operative well-being of patients with benign vocal cord lesions using VHI-10 among patients attending our Outpatient department. The study was a hospital based observational study with prospective study design, conducted over a period of 17 months (August 2019 to December 2020) on 53 patients who were clinically diagnosed to have benign vocal cord lesion and underwent micro laryngeal surgery followed by histopathological confirmation. Follow-up of the participants was done on 4th and 8th week post-operatively. Visualization of the condition of the laryngeal structures using laryngoscope assessment of VHI-10 score was done at each follow-up visit. In our study, out of 53 study participants, approximately one-third of the cases were seen in the 5th decade, that is, 40-49 years. The mean (±SD) age of the study participants was 43.2 (±12.1) years. There was male predominance (73.6%) with male to female ratio of 2.78:1. Majority of the patients had voice-demanding profession with history of vocal abuse. In cases of non-professional voice users, the highest incidence was noted in homemakers (11.4%). Smoking was noted in nine male patients while all the female patients were non-smokers. Habit of alcohol consumption was seen in 15.1% patients and 7.5% patients had habit of other substance abuse such as tobacco chewing, betel nut chewing, etc. Vocal polyps were the most common benign lesions found in 43.3% of the patients. Preoperatively mean (± SD) VHI-10 score was 20.7 (±3.5) which significantly decreased to 12.6 (±2.5) at 4th week post-operatively and 8.5 (±2.3) at 8th week post-operatively. Mean differences between pre-operative and post-operative scores were statistically significant (P < 0.01), depicting that there was improvement in the voice of the patients post-operatively. The VHI-10 scale is shown to be a good and convenient tool for assessing patient voice handicap and determining improvement post-operatively. Wider studies with larger sample size in different parts of the country may be recommended to validate the findings of the study. In addition to surgical excision of lesion, speech therapy, and patient counselling are indubitably essential measures that should be undertaken for each patient so as to alleviate the handicapping effect of voice disorder and improve the overall quality of life of the individuals.