Voice rest after microlaryngoscopy: current opinion and practice.

Abstract

Although voice rest is often recommended after excision of benign mucosal vocal fold lesions, no standard of care exists regarding the use, duration, or extent of vocal restrictions. This prospective study is intended to explore current opinions and practices of otolaryngologists regarding the use of complete and relative voice rest. A 16-item survey was mailed to all active U.S. members of the American Academy of Otolaryngology-Head and Neck Surgery (n = 7,321) regarding use of complete and relative voice rest after surgical excision of vocal fold nodules, polyps, and cysts. Treatment preference questions used a Likert 5-point scale with end anchors of 1 equaling "never" and 5 equaling "always". The response rate was 16.5% (1,208 respondents). Differences by lesion type were not statistically significant, suggesting that surgeons consider the mucosal disruption resulting from the surgery to be similar across lesions. Approximately 51.4% (620) favored complete voice rest. Approximately 62.3% (753) favored relative voice rest. Approximately 18% (213) of the respondents who "always" recommend complete rest also "always" recommend relative rest. The most common duration for both types of rest is 7 days. There is a clear preference for the use of voice rest, but the specific type (complete or relative) is controversial, and a notable percentage of respondents (15%) do not favor any type of voice rest. It is likely that the lack of uniformity of opinions and practices reflects the absence of empirical data. Prospective clinical trials are needed to guide clinical standards of care.